Cycloserine and Breastfeeding

Summary of use during lactation

Limited information from an old study indicates that maternal doses of cycloserine of 1 gram daily produce moderate levels in milk. If cycloserine is required by the mother, it is not a reason to discontinue breastfeeding, especially if the infant is older than 2 months. Exclusively breastfed infants should be monitored if this drug is used during lactation, possibly including measurement of serum levels to rule out toxicity if there is a concern.

Drug levels in milk and infant serum

Maternal Levels. In 5 women (time postpartum not stated) receiving oral cycloserine 250 mg 4 times daily, single milk levels from each of the mothers (collection times not stated) averaged 13.4 mg/L (range 6 to 19 mg/L).[1] It is estimated that a fully breastfed infant would receive 1.7 mg/kg daily or 11 to 28% of a usual infant dosage.[2,3] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

No adverse effects were noted in 5 in breastfed infants (ages not stated) whose mothers were taking oral cycloserine 250 mg 4 times daily.[1] Cycloserine was used as part of multi-drug regimens to treat 5 women with multidrug-resistant tuberculosis, 4 throughout pregnancy and postpartum and the other postpartum only. The infants were breastfed (extent and duration not stated). At age 1.25, 1.8, 3.9, 4.6 and 5.5 years, the children were developing normally except for a mild speech delay in one and hyperactivity in another.[4]

Effects on lactation and breastmilk

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

References

1. MortonRF McKennaMH CharlesE Studies on the absorption, diffusion, and excretion of cycloserine. Antibiot Annu 1955-1956 1956 31 169 72 13355263 PubMed
2. SniderDEJr PowellKE Should women taking antituberculosis drugs breast-feed? Arch Intern Med 1984 144 589 90 6367682 PubMed
3. TranJH MontakantikulP The safety of antituberculosis medications during breastfeeding. J Hum Lact 1998 14 337 40 10205455 PubMed
4. DrobacPC del CastilloH SweetlandA Treatment of multidrug-resistant tuberculosis during pregnancy: long-term follow-up of 6 children with intrauterine exposure to second-line agents. Clin Infect Dis 2005 40 1689 92 15889370 PubMed