Lactation risk category

Metronidazole is effective in the treatment of acne rosacea although for this indication its mechanism of action is not clearly understood. Long-term topical use for this indication is not recommended. This advice is founded on experiments in animals showing a carcinogenic effect by oral administration of metronidazole. There is inadequate evidence of the safety of metronidazole in human pregnancy. Metronidazole is classified in Lactation Risk Category L3 (moderately safe). 

Ramoz LL, Patel-Shori NM. Recent changes in pregnancy and lactation labehng retirement of risk categories. Pharmacotherapy April 2014 34(4) 389-95. http //dx.doi.org/10.1002/pharl385. Epub January 4,2014. 

Flucytosine is contraindicated in patients with known hypersensitivity to the drug. Flucytosine is used cautiously in patients with bone marrow depression and with extreme caution in those with renal impairment. The drug is also used cautiously during pregnancy (Category C) and lactation. When flucytosine and amphotericin B are administered concurrently, the risk of flucytosine toxicity is increased. 

Cinoxacin is contraindicated in patients with known hypersensitivity to the individual drug and in patients with anuria. Cinoxacin is a Pregnancy Category B drug and should be used with caution during pregnancy and lactation. Cinoxacin is used with caution in patients with hepatic impairment. When cinoxacin is administered with probenecid, there is a risk for lowered urine concentration of cinoxacin. 

The FDA labels hydromorphone as a Category C. Hydromorphone readily crosses the placenta. The Thompson Lactation Rating states that infant risk is minimal. 

Table 7.15 presents water volume intakes among women of childbearing age, pregnant women, and those who are lactating. Such intake estimates provide a measure of potential lead exposure risks to the fetus and the newborn when the concentrations of Pb in these water sources are known. In terms of total water daily consumption, the volumes are similar in all three categories for mean (1,157—1,310 ml/day) or higher percentile consumption rates. 

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