Oral Terbinafine and Topical Nystatin

[SMM]

Good Afternoon,

I have looked at all the information avaliable by the manufacturer, on websites and the previous answers by Infant Risk and am still unsure about whether a combination of Oral Terbinafine and Topical Nystatin would actually (realisticly) be safe while breastfeeding. It is listed as a contraindication by the manufacturer.

My specialist has prescribed 250mg oral terbinafine daily for 8 weeks, along with Nystatin cream once daily for an extensive fungal rash that covers areas on my legs up to my stomach (none around my breast area). He told me I would have to wean before starting this medication , which I'm finding difficult and I don't think my toddler is ready just yet.

We breastfeed 2x a day to sleep (lunch nap and bedtime). My child is 26months .

Is it safe to start these medications or do I need to persist with weaning ?

Any advice is appreciated.

[kaytlin]

We don't typically like long-term terbinafine while breastfeeding. However, in your case, I wouldn't anticipate harm. You have a few things going for you: 8 weeks isn't as long as we commonly see, milk production at 26 months postpartum is usually pretty low, and a 26-month-old should have enough liver function to clear the drug (unlike young babies).

Dr. Krutsch