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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. </p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK501043_"><span class="title" itemprop="name">Nalidixic Acid</span></h1><p class="small">Last Revision: <span itemprop="dateModified">July 15, 2024</span>.</p><p><em>Estimated reading time: 1 minute</em></p></div><div class="body-content whole_rhythm" itemprop="text"><p>CASRN: 389-08-2</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134975483" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134975483" alt="image 134975483 in the ncbi pubchem database" /></a><div id="LM194.Drug_Levels_and_Effects"><h2 id="_LM194_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM194.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Limited information indicates that maternal doses of nalidixic acid up to 2 grams daily produce low levels in milk and would usually not be expected to cause any adverse effects in breastfed infants with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). Nalidixic acid should be avoided while breastfeeding a glucose-6-phosphate dehydrogenase (G6PD) deficient infant. Other agents are preferred, especially while nursing a newborn or preterm infant.</p></div><div id="LM194.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> One paper reported old, unpublished data obtained from the manufacturer in which a breastmilk concentration of 2 mg/L was found at an unspecified time in 4 women taking nalidixic acid 1 gram orally 4 times daily.[<a class="bk_pop" href="#LM194.REF.1">1</a>]</p><p>Thirteen lactating women were given 2 grams of nalidixic acid as a single dose between the third and eighth day postpartum. The average concentration of nalidixic acid in milk during the first four-hour collection period was 0.64 mg/L (range 0.3 to 1.1 mg/L); concentration in milk from other collection periods were as follows: 0.43 mg/L at 4 to 7 hours; 0.2 mg/L at 7 to 10.5 hours; 0.1 mg/L at 10.5 to 16 hours and 0.02 mg/L at 16 to 24 hours after the dose. Using the peak milk level data from this study, the authors estimated that an exclusively breastfed infant would receive a maximum of 300 mcg daily with this maternal dosage regimen, or less than 0.3% of an infant dose.[<a class="bk_pop" href="#LM194.REF.2">2</a>]</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM194.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Decreased weight gain, pallor, jaundice occurred in a 16-day-old infant probably caused by hemolytic anemia induced by maternal use of nalidixic acid orally 1 gram four times daily and amobarbital 65 mg orally three times daily. The infant developed jaundice, hyperbilirubinemia, reticulocytosis, eosinophilia, Heinz bodies and other signs of hemolysis 7 days after its mother was started on nalidixic acid. No G-6-PD deficiency or hemoglobin Zurich could be demonstrated.[<a class="bk_pop" href="#LM194.REF.1">1</a>]</p></div><div id="LM194.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM194.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p><a href="/books/n/lactmed/LM69/">Ciprofloxacin</a>, <a href="/books/n/lactmed/LM157/">Levofloxacin</a>, <a href="/books/n/lactmed/LM202/">Nitrofurantoin</a>, <a href="/books/n/lactmed/LM414/">Trimethoprim</a></p></div><div id="LM194.References"><h3>References</h3><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="LM194.REF.1">Belton
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EM, Jones
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RV. Haemolytic anaemia due to nalidixic acid.
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Lancet
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1965;286:691
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[<a href="https://pubmed.ncbi.nlm.nih.gov/4158226" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4158226</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="LM194.REF.2">Traeger
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A, Peiker
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G. Excretion of nalidixic acid via mother's milk.
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Arch Toxicol Suppl
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1980;4:388-90
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[<a href="https://pubmed.ncbi.nlm.nih.gov/6933944" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6933944</span></a>]</div></dd></dl></div></div><div id="LM194.Substance_Identification"><h2 id="_LM194_Substance_Identification_">Substance Identification</h2><div id="LM194.Substance_Name"><h3>Substance Name</h3><p>Nalidixic Acid</p></div><div id="LM194.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>389-08-2</p></div><div id="LM194.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Anti-Infective Agents, Urinary</p><p>Antibacterial Agents</p><p>Quinolones</p></div></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></div><div id="bk_toc_contnr"></div></div></div>
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