Is Rifapentine 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 Rifapentine. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
The amount of rifapentine and its metabolite in milk is insufficient to treat tuberculosis in the breastfed infant. The Centers for Disease Control and Prevention and other professional organizations state that breastfeeding should not be discouraged in women taking rifapentine.[1-3] Monitor the infant for signs of liver toxicity. Breastmilk may be stained a red-orange color.
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
Rifapentine is metabolized to 25-O-desacetylrifapentine, which has about half the in vitro activity of rifapentine against M. tuberculosis. 25-O-desacetylrifapentine has a longer half-life and accumulates over time, increasing its antimycobacterial impact.
Maternal Levels. In a study of pregnant and postpartum women with latent tuberculosis infection, participants received 12 directly observed once-weekly doses of rifapentine 900 mg, isoniazid 900 mg, and pyridoxine 25 to 100 mg. In 22 women who donated milk samples, the average rifapentine milk concentrations were about 280 mcg/L at 3 hours after the first dose, 533 mcg/L at 6 hours after the second dose and 293 mcg/L at 24 hours after the last dose. The average 25-O-desacetylrifapentine milk concentrations were about 67 mcg/L at 3 hours after the first dose, 180 mcg/L at 6 hours after the second dose and 360 mcg/L at 24 hours after the last dose.[4]
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 Rifapentine 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 “Rifapentine” (LM705). 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.