Levamisole and Breastfeeding

Summary of use during lactation

Levamisole is no longer marketed for human use in the United States because can cause agranulocytosis, but it is used as an anthelmintic in other countries. No published information is available about its excretion into breastmilk. Some information indicates that maternal use may be acceptable during breastfeeding. However, because there is little published experience with levamisole during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. The World Health Organization recommends against breastfeeding with maternal levamisole therapy.

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

A cohort of 33 infants who were breastfed (extent not stated) by hospitalized mothers taking nifurtimox was followed in the Democratic Republic of the Congo. Thirty mothers took a full course of 30 doses of oral nifurtimox 15 mg/kg daily and all received 14 doses of intravenous eflornithine 400 mg/kg daily for 7 days for human African trypanosomiasis. (sleeping sickness). Six nursing mothers also took levamisole. No serious adverse events were reported in any of the breastfed infants.[1,2]

Effects on lactation and breastmilk

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

References

1. SchmidC KuemmerleA BlumJ In-hospital safety in field conditions of nifurtimox eflornithine combination therapy (NECT) for T. b. gambiense sleeping sickness. PLoS Negl Trop Dis 2012 6 e1920 23209861 PubMed
2. KuemmerleA SchmidC KandeV Prescription of concomitant medications in patients treated with nifurtimox eflornithine combination therapy (NECT) for T.b. gambiense second stage sleeping sickness in the Democratic Republic of the Congo. PLoS Negl Trop Dis 2020 14 e0008028 31986140 PubMed