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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Trimethoprim - Drugs and Lactation Database (LactMed&reg;) - NCBI Bookshelf</title>
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id="jr-fip-next" class="wsprkl btn" title="Jump to next match">&#9654;</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501286_"><span class="title" itemprop="name">Trimethoprim</span></h1><p class="fm-aai"><a href="#_NBK501286_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 2 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 738-70-5</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/135269979" title="View this structure in PubChem" class="img_link" ref="pagearea=body&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&amp;sid=135269979" alt="image 135269979 in the ncbi pubchem database" /></a><div id="LM414.Drug_Levels_and_Effects"><h2 id="_LM414_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM414.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Because of the low levels of trimethoprim in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.</p></div><div id="LM414.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> In 20 mothers in the immediate postpartum period given oral trimethoprim, peak milk levels occurred 3 hours after the dose. In 14 of these women who received a daily dosage of 320 mg, the peak milk level averaged 2.4 mg/L and the trough averaged 1 mg/L. In 6 other women who received a daily dosage of 480 mg, the peak milk level averaged 4 mg/L and the trough averaged 1.5 mg/L. The authors calculated that a breastfed infant would receive a daily dosage of 0.75 mg with a maternal dosage of 320 mg daily and 1.7 mg with a maternal dosage of 480 mg.[<a class="bibr" href="#LM414.REF.1" rid="LM414.REF.1">1</a>,<a class="bibr" href="#LM414.REF.2" rid="LM414.REF.2">2</a>]</p><p>Forty women in the early postpartum period received oral co-trimoxazole and had milk levels measured several times daily for 5 days. After trimethoprim doses of 320 mg daily, average milk levels were about 2 mg/L. Milk levels increased to about 3 mg/L by day 5 of therapy. In 10 other women who received trimethoprim 480 mg daily, average milk levels were only slightly higher.[<a class="bibr" href="#LM414.REF.3" rid="LM414.REF.3">3</a>] With the usual dose of trimethoprim 320 mg daily, an exclusively breastfed infant would be expected to receive 0.45 mg/kg daily of trimethoprim. This is very low in comparison to the established treatment dosages of 8 mg/kg daily for infants over 2 months of age.</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM414.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>In one study, no adverse effects were noted in infants during 4 days of maternal therapy with co-trimoxazole.[<a class="bibr" href="#LM414.REF.1" rid="LM414.REF.1">1</a>]</p><p>In a telephone follow-up study, 12 nursing mothers reported taking co-trimoxazole (dosage unspecified). Two mothers reported poor feeding in their infants. Diarrhea was not reported among the exposed infants.[<a class="bibr" href="#LM414.REF.4" rid="LM414.REF.4">4</a>]</p></div><div id="LM414.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="LM414.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p><a href="/books/n/lactmed/LM69/?report=reader">Ciprofloxacin</a>, <a href="/books/n/lactmed/LM157/?report=reader">Levofloxacin</a>, <a href="/books/n/lactmed/LM202/?report=reader">Nitrofurantoin</a></p></div><div id="LM414.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM414.REF.1">Arnauld
R, Soutoul
JH, Gallier
J, et al.
Study on the passage of trimethoprim into mother's milk.
Ouest Med
1972;25:959-64.</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM414.REF.2">Borderon
E, Soutoul
JH, Borderon
JC, et al.
Excretion of antibiotics in human milk.
Med Mal Infect
1975;5:373-6.</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM414.REF.3">Miller RD, Salter AJ. The passage of trimethoprim/sulfamethoxazole into breast milk and its significance. In, Daikos CK, ed. Progress in Chemotherapy. Antibacterial chemotherapy 1974;1:687-91.</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM414.REF.4">Ito
S, Blajchman
A, Stephenson
M, et al.
Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication.
Am J Obstet Gynecol
1993;168:1393-9.
[<a href="https://pubmed.ncbi.nlm.nih.gov/8498418" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 8498418</span></a>]</div></dd></dl></dl></div></div><div id="LM414.Substance_Identification"><h2 id="_LM414_Substance_Identification_">Substance Identification</h2><div id="LM414.Substance_Name"><h3>Substance Name</h3><p>Trimethoprim</p></div><div id="LM414.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>738-70-5</p></div><div id="LM414.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>Folic Acid Antagonists</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><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></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501286_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">November 15, 2024</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&amp;targetsite=external&amp;targetcat=link&amp;targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed&#x000ae;) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Trimethoprim. [Updated 2024 Nov 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM1403/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM417/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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