Cytarabine and Breastfeeding

Summary of use during lactation

No information is available on the excretion of cytarabine into breastmilk. However, the drug has a short half-life of 2 to 3 hours after intravenous administration, so it should be eliminated from milk a day after intravenous administration.[1] Very little information is available on the use of cytarabine during breastfeeding. In one case, a mother began breastfeeding her infant 3 weeks after receiving cytarabine, mitoxantrone and etoposide intravenously, with no apparent harm to her infant. After intrathecal administration of the liposomal formulation of cytarabine, drugs levels in plasma are barely detectable, and are unlikely to appear in milk in clinically relevant amounts.

Drug levels in milk and infant serum

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

Effects in breastfed infants

One mother received 3 daily doses of 6 mg/sq. m. of mitoxantrone intravenously along with 5 daily doses of etoposide 80 mg/sq. m. and cytarabine 170 mg/sq. m. intravenously. She resumed breastfeeding her infant 3 weeks after the third dose of mitoxantrone at a time when mitoxantrone was still detectable in milk. The infant had no apparent abnormalities at 16 months of age. However, after 3 weeks of abstinence from breastfeeding, it is unlikely that cytarabine was present in milk during breastfeeding.[2]

Effects on lactation and breastmilk

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

References

1. Hamada A, Kawaguchi T, Nakano M. Clinical pharmacokinetics of cytarabine formulations. Clin Pharmacokinet 2002;41:705-18.12162758 PubMed
2. Azuno Y, Kaku K, Fujita N, et al. Mitoxantrone and etoposide in breast milk. Am J Hematol 1995;48:131-2.7847330 PubMed