Summary of Use during Lactation

Limited data indicate that ivermectin is poorly excreted into breastmilk after oral administration. Amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. No data are available on excretion after topical administration, but amounts in breastmilk should be less than after oral administration. Avoid application to the breast area where the infant might directly ingest the drug.

Drug Levels

Maternal Levels. Four mothers who had lost their infants at term were given a single 150 mcg/kg dose of oral ivermectin. Ivermectin was detected in milk within 1 hour after the dose and for 72 hours after the dose. The average peak milk level was 15 mcg/L (range 11 to 21 mcg/L) and occurred 4 hours after the dose in 2 women, 6 hours in another and 12 hours after the dose in the fourth. The mean milk level was 9.85 mcg/L.[1][2] Using the mean milk level data from this study, an exclusively breastfed infant would receive an average dose of 1.47 mcg/kg after a maternal dose of 150 mcg/kg, or 0.98% of the weight-adjusted maternal dose.

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

Effects in Breastfed Infants

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

Effects on Lactation and Breastmilk

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

References

1.

Ogbuokiri JE, Ozumba BC, Okonkwo PO. Ivermectin levels in human breastmilk. Eur J Clin Pharmacol. 1993;45:389-90. [PubMed: 8299677]

2.

Ogbuokiri JE, Ozumba BC, Okonkwo PO. Ivermectin levels in human breast milk. Eur J Clin Pharmacol. 1994;46:89-90. Letter. [PubMed: 8005194]

Substance Name

Ivermectin

CAS Registry Number

70288-86-7

Drug Class

• Breast Feeding
• Lactation
• Anti-Infective Agents
• Antiparasitic Agents
• Insecticides
• Macrolides