Bedaquiline

Data from two women taking bedaquiline and one of their breastfed infants indicate that exposure of the infant to the drug via breastmilk is substantial, with the breastfed infant having a therapeutic plasma level. The clinical consequences of this exposure are unknown. The drug could protect the infant from multidrug-resistant tuberculosis, or could result in adverse effects. Monitor breastfed infants for adverse reactions, such as liver toxicity, nausea, inadequate weight gain, arthralgia, headache, hemoptysis, and chest pain.[1] The manufacturer states that because of the potential for serious adverse reactions in a breastfed infant, breastfeeding is not recommended during treatment and for 27.5 months (5 times the half-life) after the last dose unless infant formula is not available. Donor milk may be a better option.