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Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.

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Drugs and Lactation Database (LactMed) [Internet].

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Hydrocortisone, Topical

Last Revision: January 18, 2021.

Estimated reading time: 1 minute

CASRN: 50-23-7

image 134971010 in the ncbi pubchem database

Drug Levels and Effects

Summary of Use during Lactation

Topical hydrocortisone has not been studied during breastfeeding. Since only extensive application of the most potent corticosteroids may cause systemic effects in the mother, it is unlikely that short-term application of topical hydrocortisone would pose a risk to the breastfed infant by passage into breastmilk. However, it would be prudent to use the least potent drug on the smallest area of skin possible. It is important to ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[1] Hydrocortisone can be applied to the breast or nipple area, but should be wiped off thoroughly prior to nursing.[2] Maternal use rectally with a cream or by suppository poses very little risk to the breastfed infant.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Topical application of a corticosteroid with relatively high mineralocorticoid activity (isofluprednone acetate) to the mother's nipples resulted in prolonged QT interval, cushingoid appearance, severe hypertension, decreased growth and electrolyte abnormalities in her 2-month-old breastfed infant. The mother had used the cream since birth for painful nipples.[3]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

(Topical) Triamcinolone, Topical

References

1.
Noti A, Grob K, Biedermann M, et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38:317–25. [PubMed: 14623482]
2.
Barrett ME, Heller MM, Fullerton Stone H, et al. Dermatoses of the breast in lactation. Dermatol Ther. 2013;26:331–6. [PubMed: 23914890]
3.
De Stefano P, Bongo IG, Borgna-Pignatti C, et al. Factitious hypertension with mineralocorticoid excess in an infant. Helv Paediatr Acta. 1983;38:185–9. [PubMed: 6874387]

Substance Identification

Substance Name

Hydrocortisone, Topical

CAS Registry Number

50-23-7

Drug Class

Breast Feeding

Lactation

Corticosteroids, Topical

Glucocorticoids

Anti-Inflammatory Agents

Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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