Levaquin and Advair for Pneumonia

[Megatron6347]

I've been prescribed 500 mg of levaquin once daily for pneumonia and Advair twice a day. I was advised to stop breastfeeding my one year old baby. Is it really necessary to stop nursing or how long do i need to wait between/after doses?

I already completed a course of azithromycin and have been taking albuterol as well.

[admin-james]

Hi, thanks for your post.

Advair is a combination of salmeterol and fluticasone. Both drugs are only barely detectable in the blood after using typical doses in an inhaler. Minimal levels in the blood means minimal levels in the milk. Only about 30% of the fluticasone in the milk will actually be absorbed by the child anyway. You should be able to breastfeed on this medication without making any changes. Albuterol is similar, but may cause a little hyperactivity in your child.

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 this medication 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. Watch out for any new rashes or change in bowel habits in your baby.

Toddlers get much less breastmilk relative to their body weight as compared with infants. Plus, their ability to handle incidental medication exposure is close to that of an adult.

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.