Sulopenem and Probenecid and Breastfeeding

Summary of use during lactation

No information is available on the clinical use of sulopenem during breastfeeding. Its excretion into breastmilk is likely similar to that of imipenem and meropenem, which produce low levels in milk that are not expected to cause adverse effects in breastfed infants. Limited information indicates that maternal doses of probenecid up to 2 grams daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush has been reported with beta-lactams, but these effects have not been adequately evaluated. Sulopenem-probenecid is acceptable in nursing mothers.

Drug levels in milk and infant serum

Maternal Levels. A woman was given probenecid 500 mg orally 4 times daily to enhance cephalexin serum levels. After 16 days of therapy at 4.5 weeks postpartum, 12 samples of breastmilk (6 pairs of fore- and hindmilk) were collected over a 16-hour period. The average concentration of probenecid in milk was 964 mcg/L, corresponding to an infant dosage of 145 mcg/kg daily and 0.7% of the maternal weight-adjusted dosage.[1] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

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

Effects on lactation and breastmilk

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

References

1. Ilett KF, Hackett LP, Ingle B, et al. Transfer of probenecid and cephalexin into breast milk. Ann Pharmacother 2006;40:986-9.16551765 PubMed