From the Guidelines
No, linezolid should not be used during breastfeeding.
Key Considerations
- The British Thoracic Society guidelines explicitly state that linezolid is contraindicated in breastfeeding women 1.
- This recommendation is likely due to the potential risks of linezolid to the infant, although the specific details are not provided in the guidelines.
- As a result, alternative treatments should be considered for breastfeeding women who require antibiotic therapy.
- It is essential to weigh the benefits and risks of using linezolid in breastfeeding women, but based on the available evidence, it is recommended to avoid its use in this population 1.
From the FDA Drug Label
Linezolid and its metabolites are excreted in the milk of lactating rats. Concentrations in milk were similar to those in maternal plasma. It is not known whether linezolid is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when ZYVOX is administered to a nursing woman
Caution is advised when using linezolid in breastfeeding women, as it is not known whether the drug is excreted in human milk. Although linezolid is excreted in the milk of lactating rats, the concentration in human milk is unknown 2 2. Exercise caution when administering linezolid to a nursing woman.
From the Research
Linezolid Use During Breastfeeding
- The use of linezolid during breastfeeding is a complex issue, and there is limited information available on its safety and efficacy in this context 3.
- A study on the transfer of linezolid into breast milk found that the relative infant dose at steady state was 15.61%, and the estimated infant dose would have been 1.84 mg/kg/day, which is well below the recommended dose given to neonates requiring linezolid drug therapy 4.
- Another study reviewed the safety of antibiotics, including linezolid, in breastfeeding infants when used to treat maternal skin and soft tissue infections from MRSA, and found that despite limited data, linezolid appears to be relatively safe in the minimal quantities nursing infants ingest through breast milk 5.
- However, the study also noted that close monitoring of breastfed infants whose mothers are receiving an antibiotic for an MRSA skin and soft tissue infection is necessary due to the paucity of data 5.
- A review of linezolid pharmacokinetics and pharmacodynamics highlighted the importance of therapeutic drug monitoring to improve linezolid dosing regimens in current clinical practice, particularly in special populations such as children and patients with renal insufficiency 6.
- The available evidence suggests that linezolid can be used during breastfeeding, but careful monitoring of the infant and consideration of the potential risks and benefits are necessary 7, 4, 5.