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Clomid and Femara

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  • Clomid and Femara

    I have read several posts about Clomid and Femara. I am breastfeeding my 2.5 yr old son about 1-2 times a day (and skipping some days) usually for 5-10 minutes. It seems that you have said that Clomid is safe, but Femara is not. My doctor would like to see studies or specific research. Is there anything you can point me to?

  • #2
    Dear nmtupperlady,

    Clomiphene (Clomid) is rated by Dr. Hale as an L4 (possibly hazardous) medication in breastfeeding, mainly because of the risk of stopping lactation. Here are some references that support that:

    1.Masala A, Delitala G, Alagna S, Devilla L, Stoppelli I, Lo DG. Clomiphene and puerperal lactation. Panminerva Med 1978; 20(3):161-163.
    2.Zuckerman H, Carmel S. The inhibition of lactation by clomiphene. J Obstet Gynaecol Br Commonw 1973; 80(9):822-823.
    3.Weinstein D, Ben-David M, Polishuk WZ. Serum prolactin and the suppression of lactation. Br J Obstet Gynaecol. 1976 Sep;83(9):679-82.

    Clomiphene appears to stimulate the release of the pituitary gonadotropins. He also does not recommend using it chronically while breastfeeding.

    Letrozole (Femara), no data are available on its transfer to human milk but he suspects low levels. However, this product works irreversibly and any present in milk could potentially suppress estrogen levels in a breastfed infant. The transfer of small amounts of this agent to an infant could seriously impair bone growth or sexual development of an infant and for this reason it is probably somewhat hazardous to use in a breastfeeding mother. It has a very long half-life (48 hours) which is concerning in a breastfed infant and could lead to higher plasma levels over time. It is not advisable to breastfeed an infant while consuming this product. Unfortunately, no data are available on its transfer into milk, and we do not have any references, the recommendation was based on the pharmacokinetic properties of the drug.

    Tassneem Abdel Karim, MD
    InfantRisk Center

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    • #3
      What would be considered chronically? I would be taking it 5 days a month. If I am not concerned about loss of milk supply, what would the other risks be?

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      • #4
        Dear nmtupperlady,

        I just discussed your concerns with Dr. Hale, how about you call us at the InfantRisk Center on 806-352-2519, hopefully we will be able to answer your questions.

        Tassneem Abdel Karim, MD
        InfantRisk Center

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