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Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.
CASRN: 14769-73-4
Drug Levels and Effects
Summary of Use during Lactation
Levamisole is no longer marketed for human use in the United States because can cause agranulocytosis, but it is used as an anthelmintic in other countries. No published information is available about its excretion into breastmilk. Some information indicates that maternal use may be acceptable during breastfeeding. However, because there is little published experience with levamisole during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. The World Health Organization recommends against breastfeeding with maternal levamisole therapy.
Drug Levels
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
A cohort of 33 infants who were breastfed (extent not stated) by hospitalized mothers taking nifurtimox was followed in the Democratic Republic of the Congo. Thirty mothers took a full course of 30 doses of oral nifurtimox 15 mg/kg daily and all received 14 doses of intravenous eflornithine 400 mg/kg daily for 7 days for human African trypanosomiasis. (sleeping sickness). Six nursing mothers also took levamisole. No serious adverse events were reported in any of the breastfed infants.[1,2]
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
References
- 1.
- Schmid C, Kuemmerle A, Blum J, et al. In-hospital safety in field conditions of nifurtimox eflornithine combination therapy (NECT) for T. b. gambiense sleeping sickness. PLoS Negl Trop Dis. 2012;6:e1920. [PMC free article: PMC3510081] [PubMed: 23209861]
- 2.
- Kuemmerle A, Schmid C, Kande V, et al. Prescription of concomitant medications in patients treated with nifurtimox eflornithine combination therapy (NECT) for T.b. gambiense second stage sleeping sickness in the Democratic Republic of the Congo. PLoS Negl Trop Dis. 2020;14:e0008028. [PMC free article: PMC7004379] [PubMed: 31986140]
Substance Identification
Substance Name
levamisole
CAS Registry Number
14769-73-4
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
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- Determination of levamisole and tetramisole in seized cocaine samples by enantioselective high-performance liquid chromatography and circular dichroism detection.[J Chromatogr A. 2014]Determination of levamisole and tetramisole in seized cocaine samples by enantioselective high-performance liquid chromatography and circular dichroism detection.Bertucci C, Tedesco D, Fabini E, Di Pietra AM, Rossi F, Garagnani M, Del Borrello E, Andrisano V. J Chromatogr A. 2014 Oct 10; 1363:150-4. Epub 2014 Jul 29.
- Review Immune-mediated agranulocytosis caused by the cocaine adulterant levamisole: a case for reactive metabolite(s) involvement.[Drug Metab Dispos. 2012]Review Immune-mediated agranulocytosis caused by the cocaine adulterant levamisole: a case for reactive metabolite(s) involvement.Wolford A, McDonald TS, Eng H, Hansel S, Chen Y, Bauman J, Sharma R, Kalgutkar AS. Drug Metab Dispos. 2012 Jun; 40(6):1067-75. Epub 2012 Mar 5.
- Cocaine adulteration with the anthelminthic tetramisole (levamisole/dexamisole): Long-term monitoring of its intake by chiral LC-MS/MS analysis of cocaine-positive hair samples.[Drug Test Anal. 2019]Cocaine adulteration with the anthelminthic tetramisole (levamisole/dexamisole): Long-term monitoring of its intake by chiral LC-MS/MS analysis of cocaine-positive hair samples.Madry MM, Kraemer T, Baumgartner MR. Drug Test Anal. 2019 Mar; 11(3):472-478. Epub 2018 Oct 17.
- Review Agranulocytosis and other consequences due to use of illicit cocaine contaminated with levamisole.[Curr Opin Hematol. 2012]Review Agranulocytosis and other consequences due to use of illicit cocaine contaminated with levamisole.Buchanan JA, Lavonas EJ. Curr Opin Hematol. 2012 Jan; 19(1):27-31.
- Chiral pharmacokinetics of tetramisole stereoisomers-Enantioselective quantification of levamisole and dexamisole in serum samples from users of adulterated cocaine.[Drug Test Anal. 2022]Chiral pharmacokinetics of tetramisole stereoisomers-Enantioselective quantification of levamisole and dexamisole in serum samples from users of adulterated cocaine.Losacker M, Hundertmark M, Zörntlein S, Röhrich J, Hess C. Drug Test Anal. 2022 Jun; 14(6):1053-1064. Epub 2022 Feb 1.
- Levamisole - Drugs and Lactation Database (LactMed®)Levamisole - Drugs and Lactation Database (LactMed®)
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