To : Erin
Re : Levaquin (levofloxacin)
Levofloxacin is just another of the fluoroquinolone antibiotics. We have no
data on its transfer into human milk. I am presently suggesting that BFing
mothers who must have a fluoroquinoline, use Trovafloxacin (Trovan). I have
enclosed the monograph from my book below. The levels published by the
manufacturer show low milk levels.
Lastly, as for radioactive substances, please check my WEB page and get the
NRC table on breastfeeding. This table is quite good, and every
breastfeeding mother who needs a radioactive substance should "hand this
printout" to the radiologist. At least this way, the radiologist might
learn something.
Regards
Tom Hale Ph.D.
-------------------------
Trovafloxacin Mesylate
Trade: Trovan, Alatrofloxacin
Can/Aus/UK:
Uses: Antibiotic
AAP: Not reviewed
Trovafloxacin mesylate is a synthetic broad-spectrum antibiotic for oral
use. The IV formula is called alatrofloxacin mesylate which is metabolized
to trovafloxacin in vivo. Trovafloxacin is a fluoroquinolone antibiotic
similar to ciprofloxacin, norfloxacin and others. Trovafloxacin was
found in measurable but low concentrations in breast milk of three
breastfeeding mothers. Following an IV dose of 300 mg trovafloxacin
equivalent, and repeated oral 200 mg doses of trovafloxacin mg daily,
breast milk levels averaged 0.8 mg/L and ranged from 0.3 to 2.1 mg per liter
of milk. This would average less than 0.4% of the maternal dose.
Alternatives: Norfloxacin, Ofloxacin
Pregnancy Risk Category: C
Adult Concerns: Dizziness, nausea, headache, vomiting, diarrhea have been
reported.
Pediatric Concerns: None reported via milk. Only small amounts are secreted
in milk.
Drug Interactions: Antacids, Morphine, Sucralfate, and iron significantly
reduce oral absorption.
AHL = 12,2 hours M/P =
PHL = PB = 76%
PK = 1,2 hours Oral = 88%
MW = 512 pKa =
Vd = 1.3
References:
1. Pharmaceutical Manufacturer's package insert, 1998.
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