Is Piperaquine safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Piperaquine. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Piperaquine is not approved for marketing in the United States by the U.S. Food and Drug Administration, but is available in other countries. Amounts in milk are very low and should not affect the breastfed infant.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Twenty-seven women received 3 doses containing 320 mg of piperaquine combined with dihydroartemisinin or sulfadoxine-pyrimethamine. Breastmilk was sampled on days 1, 2, 3 to 5, 7 to 11, and 14 to 17 after delivery. Serum concentration data were analyzed using a population pharmacokinetic model (NONMEM) and breastmilk concentrations were estimated from plasma concentrations using the milk-to-plasma ratio. The estimated absolute daily infant dosage was 0.41 mcg/kg, which corresponds to a relative infant dose of 0.004%. The maximum simulated relative infant dosage from any dosing scenario was 2.5%.[1]
A physiologically based pharmacokinetic model has been developed that adequately predicts piperaquine excretion into breastmilk.[2]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Piperaquine is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Piperaquine” (piperaquine). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.