/Rosemary asks://

Does anyone have any information about the safety of Hydroxyurea while breastfeeding? In the copy of Hale I have (2008), it's classified as L2, but everywhere else I look (LactMed, NIH, the package insert) says it's contraindicated. This would be for chronic use, not just during crises.

/Hale/'s/Infant Risk app lists Hydroxyurea as an L3 (probably safe) but the text provides what seems to me to be contradictory information.  On the one hand, it says, "Following a dose of 500 mg three times daily for 7 days, the concentration of hydroxyurea in breastmilk averaged 5.1 mg/L (range 3.8 - 8.4 mg/L).  This is about 4.3% of the maternal dose which is probably too low to have clinical effects in a breastfeeding infant."

However, it goes on to say, "As this product is potentially toxic, mothers receiving hydroxyurea should probably withhold breastfeeding for a minimum of 12-24 hours after the dose."

This is a situation where I would recommend either the mother or I call the Infant Risk Center at 806-352-2519 and get information more specific to the mother's case, straight from the expert.

Spencer, BfUSA BC and Family Physician

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        E. Spencer Joslin, MD
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