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Tacrolimus and Breastfeeding

Because tacrolimus has been shown to pass through breast milk, the manufacturer of the drug recommends that women not take it while breastfeeding. Tacrolimus could cause feeding problems, excessive crying, and tremors in a nursing infant whose mother took the drug. Before taking tacrolimus while breastfeeding, make sure to discuss the potential risks with your healthcare provider.

Can Breastfeeding Women Take Tacrolimus?

Tacrolimus (Prograf®, Protopic®) is a prescription medication approved in oral and injectable forms to prevent transplant rejection after a kidney, heart, or liver transplant. It is also available as an ointment approved to treat moderate-to-severe symptoms of atopic dermatitis (commonly called eczema).
 
Tacrolimus is known to pass through breast milk in humans. The manufacturer recommends that women who are receiving tacrolimus treatment not breastfeed. Therefore, if you are breastfeeding or planning to start, talk with your healthcare provider prior to taking this medication.
 

More Information on Tacrolimus and Breastfeeding

As mentioned, tacrolimus is known to pass through breast milk. However, based on reports of women who took the drug to prevent transplant rejection, only a small amount is expected to reach the nursing infant. In addition, the drug has not been reported to cause any significant risks in nursing infants. However, more research is needed before all potential risks can be ruled out.
 
Tacrolimus ointment is a topical medicine, which means it is applied directly on the skin. Only small amounts of the drug are expected to be absorbed into the bloodstream with normal use. However, certain factors may increase the amount of tacrolimus absorbed into the bloodstream, such as:
 
  • Using the medicine more often than recommended
  • Using it on large areas of the skin
  • Covering the treated skin with a bandage or dressing
  • Applying the ointment to skin that has open sores.
 
Also, people with certain skin conditions may absorb more tacrolimus than normally expected.
 
If your healthcare provider recommends this medicine while breastfeeding, watch for any possible tacrolimus side effects in your infant. Talk to your child's healthcare provider if your child develops problems such as:
 
  • Problems feeding
  • Tremors
  • Diarrhea
  • Excessive crying
  • Difficulty sleeping
  • Anything else that just doesn't seem right.
 
If you are using tacrolimus ointment, it is probably best to avoid applying the medicine to the breast or nipple area, which would directly expose a nursing infant to the medicine. Also, try to limit direct skin-to-skin contact with areas of the skin where tacrolimus has been applied.
 
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Tacrolimus Drug Information

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