A 40-year -old woman was taking cefpodoxime (Vantin and others) 200 mg twice daily for 4 days for fever and cough.  She complained of milk from both breasts that started 2 days of this antibiotic treatment.  She had no central nervous system complaints and reported no sexual activity for 10 days.  A serum pregnancy test was performed, which was negative.  She had not recently had a child nor was she breastfeeding.  She had normal renal function and her thyroid-stimulating hormone level was normal.  The serum prolactin level was measured at 6,854 pmol/L (for menopausal women, normal is 625 to 4,028 pmol/L).  A magnetic resonance imaging of her brain was normal.

The cefpodoxime was discontinued and by 1 week later the prolactin level had fallen to 1,111 pmol/L and the breast discharge stopped.  One month later, the prolactin level was down to 778 pmol/L.

The authors report that this is the first report of galactorrhea associated with cefpodoxime-induced hyperprolactinemia.  Other drugs known to cause galactorrhea through antidopaminergic effects include antipsychotic agents and metoclopramide.

Khurana V, Gambhir IS.  Cefpodoxime-induced hyperprolactinemic galactorrhea.  Ann Intern Med. 2010; 152 (2):136.

Frank J. Nice, RPh, DPA, CPHP
Check out my Website and Book, "Nonprescription Drugs for the Breastfeeding Mother" at: 
www.nicebreastfeeding.com


 		 	   		  
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