Is Canflopen (generic name) safe to use in the treatment of mastitis during breastfeeding?

Safety of Canflopen (Dicloxacillin) for Mastitis Treatment During Breastfeeding

Dicloxacillin (Canflopen) is safe and recommended for the treatment of mastitis in breastfeeding women, with a very low relative infant dose of only 0.03% of the maternal dose.

Medication Safety During Breastfeeding

When evaluating medications for breastfeeding women, safety is determined by:

• The amount of medication that transfers into breast milk
• The relative infant dose (RID) - considered safe when <10% of maternal dose 1
• The medication's absorption in the infant's gastrointestinal tract
• The potential effects on the infant

Dicloxacillin for Mastitis Treatment

Safety Profile

• Dicloxacillin has very limited transfer into breast milk, with a maximum concentration of only 67.6 ng/mL 2
• The relative infant dose (RID) is calculated to be just 0.03%, which is significantly below the 10% threshold considered safe 2
• The limited transfer is likely due to dicloxacillin's high plasma protein binding, which restricts its penetration into breast milk 2

Effectiveness

• Dicloxacillin is effective against Staphylococcus aureus, the most common bacterial cause of mastitis 3
• As a penicillin-class antibiotic, it falls within the category of medications that are generally considered safe during breastfeeding 1

Treatment Recommendations for Mastitis

First-line approach:

1. Non-pharmacological measures:

   • Ensure frequent, complete emptying of the breast
   • Optimize breastfeeding technique (possibly with lactation consultant assistance)
   • Apply heat to the affected area
   • Continue breastfeeding from the affected breast 3

2. When antibiotics are needed:

   • Dicloxacillin or other anti-staphylococcal penicillins (e.g., cephalexin) are preferred 3
   • Treatment should begin promptly to prevent complications like breast abscess

Important considerations:

• Continued breastfeeding during mastitis treatment is recommended and generally safe for the infant 3
• The benefits of treating mastitis effectively outweigh the minimal risk of medication exposure through breast milk
• Untreated mastitis can lead to breast abscess formation and premature cessation of breastfeeding 4

Precautions

• Exercise caution in infants with known hypersensitivity to penicillins 2
• Extra vigilance may be needed for infants less than 6 weeks of age due to their immature hepatic and renal function 5
• Take medication immediately after breastfeeding to maximize clearance time before the next feeding 5

In conclusion, dicloxacillin (Canflopen) is a safe and effective choice for treating mastitis in breastfeeding women, with minimal transfer into breast milk and no significant risk to the nursing infant.