# Norfloxacin and Amoxycillin while EBF



## Nimm2 (Apr 11, 2008)

I am really upset because I have been given Amoxycillin in a high dose for 10 days right after the birth of my baby already 1000 mg (2 x 500 mg capsules) twice a day.

Now I am supposed to take it for yet another week and on top of that another antibiotic at the same time called Norfloxacin.

The doctors knows I am breastfeeding.

Now I looked up Norfloxacin and I find this:

http://drugsafetysite.com/norfloxacin:

Quote:

Breast Feeding Summary

The administration of norfloxacin during breast feeding is not recommended because of the potential for arthropathy and other serious toxicity in the nursing infant (5). Phototoxicity has been observed with some members of the quinolone class of drugs when exposure to excessive sunlight (i.e., ultraviolet [UV] light) has occurred (5). Well-differentiated squamous cell carcinomas of the skin have been produced in mice who were exposed chronically to some quinolones and periodic UV light (e.g., see Lomefloxacin), but studies to evaluate the carcinogenicity of norfloxacin in this manner have not been conducted.

The manufacturer reports that the drug was not detected in milk following a single 200-mg oral dose administered to nursing mothers (5). However, this dose is one-fourth of the normal recommended daily dose and, thus, may not be indicative of excretion after normal use. Similarly, a 1991 review cited a study that the antibacterial was undetectable in milk, but no details on dosage were given (13).

In a study published in 1994, lactating ewes were administered a single IV dose of norfloxacin (25 mg/kg) during nursing (14). Milk concentrations of the antibacterial agent were up to 40 times higher than corresponding serum levels and therapeutic levels were measured in the serum of suckling lambs.

Although it is not known whether norfloxacin is excreted into human milk, the high concentrations of the drug found in the milk of ewes, the relatively low molecular weight (about 319), and the excretion of other quinolones (see Ciprofloxacin and Ofloxacin), are evidence that the passage of norfloxacin most likely occurs. Because of the potential for toxicity, the drug should be avoided during breast feeding.

5. Product information. Noroxin. Merck & Company, 1997.

13. Takase Z, Shirafuji H, Uchida M. Basic and clinical studies of AM-715 in the field of obstetrics and gynecology. Chemotherapy (Tokyo) 1981;29(Suppl 4):697-704. As cited by Anderson PO. Drug use during breast-feeding. Clin Pharmacol 1991;10:594-624.

14. Soback S, Gips M, Bialer M, Bor A. Effect of lactation on single-dose pharmacokinetics of norfloxacin nicotinate in ewes. Antimicrob Agents Chemother 1994;38:2336-9.
and

http://www.medsafe.govt.nz/profs/Dat...oxacintab.htm:

Quote:

Use in lactation

It is not known whether norfloxacin is excreted in human milk. When a 200 mg dose of norfloxacin was administered to breastfeeding mothers, norfloxacin was not detected in human milk. However, the dose studied was low. Also, there is a potential for serious adverse reactions from norfloxacin in breastfed infants, as other drugs in this class are secreted in human milk. Thus, a decision should be made to discontinue breastfeeding or to discontinue the drug at least 24 to 48 hours before restarting breastfeeding, taking into account the importance of the drug to the mother.


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## MCatLvrMom2A&X (Nov 18, 2004)

Have you taken the Norflraxin yet? If you havnt I wouldnt. I bet you money there is another med you can take that is similar but safer.

The amox I dont think it is a problem I took it several times while bfing both kids for sinus infection.


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## Nimm2 (Apr 11, 2008)

Yes already started it for 2 days 400 mg two times per day, only had time now to look it up








Now I have another 3 days worth I am supposed to take, but I don't know if I should just leave it.

The doctor gave it to me at a check-up of my large episiotomy a week after I left hospital. I told him I started to have pain 9 days after the birth what felt to me like it was pain in my uterus.
He said it must be a urinary tract infection and I said I am not sure because I know what that feels like and it's not the same and I drink a lot of water, too. That's what he gave me the Norfloxacin for. He insisted the pain must be from a UTI.


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## trancechylde (Apr 14, 2008)

I had to take Amoxycillin for 12 days when DS was just a few weeks old.
I wasn't happy about it, but there weren't any ill-effects.

I'm sure your LO will be fine


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## evlu (Oct 14, 2006)

Here's more information that's less scary about the Norflaxacin:
http://toxnet.nlm.nih.gov/cgi-bin/si...temp/~FAvZce:1

And the amoxycillin is generally considered safe:
http://toxnet.nlm.nih.gov/cgi-bin/si...temp/~tKH3ty:1


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## MissRubyandKen (Nov 2, 2005)

Did the doctor even test your urine?


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## MommyJoia (Oct 31, 2007)

according to the aap amoxycillin is safe, only a L1.

Norflaxin wasn't on the list:

http://www.kellymom.com/health/meds/...oved-meds.html


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## marisa724 (Oct 31, 2003)

Dr. Hale (Medications and Mother's Milk) gives Norfloxacin a category L3 (Moderately Safe). Although there is some evidence that it does not pass into the milk, there just isn't enough available information at this time. Hale often categorizes this type of situation as L3 just to be safe. He also mentions that this is one of several drugs in this family that would be preferred over others for use in a breastfeeding mom.

As an alternative, in the same family of fluoroquinolone antibiotics, he suggests ofloxacin. Ofloxacin is actually a category L2 and approved for nursing moms by the AAP. You might call to see if your dr. will switch your prescription.

Frankly, though, loading you up with so many antibiotics without even testing you for infection is sort of troublesome. At the very least I hope you're loading up on probiotics as well, and I hope that you've got lots of help there at home. Take care of yourself!


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## tanyalynn (Jun 5, 2005)

I was going to mention probiotics. Whatever you decide on the norfloxacin, starting probiotics now and continuing them for a long time would be prudent. I never could acquire a taste for yogurt (though there are lots of mamas around here who can tell you how to make it) but fermented veggies are yummy and I think even easier to make then yogurt. Pills may be the easier way to start, though.








that you haven't gotten your questions answered from your doc.


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## Nimm2 (Apr 11, 2008)

No he didn't do any tests. I am only finishing the Amoxycillin now and just leaving the Norfloxacin alone.

I have been taking acidophilus daily for 2-3 years and eat a lot of yoghurt.

Thank you for the links.


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