Safety in Lactation: Mucolytics and other drugs for cystic fibrosis

Additional information relating to breastfeeding

To be used in conjunction with individual drug entries for specific information and guidance.

There is no evidence to support the use of mucolytics (carbocisteine, erdosteine, mecysteine) with breastfeeding. Although probably acceptable due to low side effects in normal use, their use should be avoided if clinically possible.

Dornase alfa for cystic fibrosis is considered acceptable due to poor bioavailability. The small number of cystic fibrosis patients clinically eligible to receive ivacaftor, with or without lumacaftor, will restrict gaining direct evidence for its safe use in breastfeeding.

CarbocisteineDornase alfaErdosteineIvacaftorLumacaftor + IvacaftorMannitolMecysteineObstetrics and gynaecologyPaediatric and neonatal medicineRespiratory disordersSafety in LactationSodium chloride