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Flagyl & Levaquin

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  • Flagyl & Levaquin

    I'm in the hospital for an infected abscess after a c section two weeks ago. The abscess has been drained and the infection isolated. The doctors say the drug needed to kill the infection is either Unasyn in IV form or Levaquin & Flagyl in pill form. I'm being discharged and I want to continue breast feeding but the doctors say that means I have to do the IV form at home for two weeks. Is there any safe dosage of Levaquin & Flagyl? Or is it always unsafe while breast feeding?

  • #2
    Hi, thanks for your post.

    We give both Levaquin and Flagyl an L2 safety rating (out of 5) ("Safer"). Both drugs will transmit 12-15% of your dose to the baby through the breastmilk. I don't know your dose of Flagyl, but 12-15% of a typical adult dose is still less than that prescribed directly to infants for their own infections. Levaquin is associated with a small chance (about 2%) of developing a temporary arthritis in children, but that goes away without any long-term damage. You can reduce your child's exposure to both medications by making sure to feed/pump immediately before you take your pills. That is when the amount of drug in the milk will be at its lowest. With both meds, also watch out for any new rashes or change in bowel habits in your baby.

    Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

    -James Abbey, MD

    The following references may be useful to your physician if he or she needs more information:

    Cahill JB, Bailey EM, Chien S, Johnson GM. Levofloxacin Secretion in Breast Milk: A Case Report. Pharmacother 2005; 25(1):116-118.

    Erickson SH, Oppenheim GL, Smith GH. Metronidazole in breast milk. Obstet Gynecol 1981; 57(1):48-50.

    Passmore CM, McElnay JC, Rainey EA, D'Arcy PF. Metronidazole excretion in human milk and its effect on the suckling neonate. Br J Clin Pharmacol 1988; 26(1):45-51.

    Heisterberg L, Branebjerg PE. Blood and milk concentrations of metronidazole in mothers and infants. J Perinat Med 1983; 11(2):114-120.
    Roe FJ. Toxicologic evaluation of metronidazole with particular reference to carcinogenic, mutagenic, and teratogenic potential. Surgery 1983; 93(1 Pt 2):158-164.

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