Safety in Lactation: Drugs for oral ulceration and inflammation

Laura Kearney, Regional Principal Medicines Information Pharmacist, Midlands and East Medicines Advice Service (Midlands site) & UK Drugs in Lactation Advisory ServicePublished

The use of oropharyngeal anti-inflammatories/analgesics is not considered to present any risk to a breastfeeding infant.
Doxycycline is considered to present negligible risk when used locally for oropharyngeal infections. Systemic use for periodontitis for up to 3 months should be avoided whilst breastfeeding. However, if clinically justified, theoretical side effects include gastro-intestinal disturbances, oral candida infection, tooth staining and hypersensitivity reactions, although these effects are unlikely to occur. Use of doxycycline may be directed by local antimicrobial policy.
Topical (oropharyngeal) salicylates are considered to present negligible risk in breastfeeding. However, the MHRA advises against the use of salicylates in children, although there is no evidence linking Reye’s syndrome with non-aspirin salicylates.