Coco asked
I began using differin topical gel (OTC) and I am also breastfeeding. I read the insert and it says not to use when breastfeeding. I stopped using it, so how long before it is safe to breastfeed again? Or until it is out of my system?
Answer
The use of medication, both oral and topical, is of great concern to breastfeeding mothers. Many medications are excreted in the breast milk in clinically significant quantities, potentially causing danger to a breastfeeding infant. While we have data on a variety of drugs, many are unfortunately not tested in regard to the extent they are excreted in the breast milk. This is especially true for topical products like Differin (adapalene).
Can Differin (Adapalene) Be Used While Breastfeeding?
According to Galderma, the manufacturer of Differin (adapalene), it is unknown whether or not the drug is distributed into breast milk. However, data indicates that Differin is poorly absorbed through intact skin. Therefore, the amount of the drug in the breast milk is expected to be extremely low and the risk to a breast feeding infant is expected to be low as well.
However, due to the lack of data, caution is recommended in regard to the use of Differin while breastfeeding. The general recommendation for Differin use while breastfeeding is as follows:
- Do not apply near the nipple area or chest area where the infant can come into direct contact with the treated area.
- It is important to consider the risk of using the medication and the potential risk to the infant from drug exposure.
The safest option is to not use the medication while breastfeeding simply due to the lack of information available. If Differin is used, do not allow the infant to come into contact with the treated area.
Is Differin (Adapalene) Absorbed By The Body?
Clinical trial data indicates that Differin is absorbed through the skin, although in very minuscule amounts. One study evaluated concentrations of the drug in 16 acne patients who applied 2 grams of Differin gel 0.3% once daily for 10 days to the face, chest and back. On day 10, concentrations of the drug were taken and 15 patients has quantifiable levels of the drug in the blood plasma, with an average of 0.553 ng/ml (nanograms per milliliter).
The same study noted that the half-life (time it takes for 50% of the drug to be metabolized) was an average of 17.2 hours. In addition, Differin was rapidly cleared from blood plasma and was not detectable 72 hours after the last application for all but one subject. Therefore, if you plan on using Differin while breastfeeding, the drug should be cleared from the blood plasma (and presumably the breast milk) about 72 hours after drug exposure.
In another study, 209 test participants applied an average of 1 gram of Differin once daily for 12 weeks.Only 3 of the 209 test subjects had detectable levels of the drug in analyzed blood plasma samples. For the three samples that did have detectable drug levels, the average concentration in the blood plasma was less than 0.25 ng/ml.
Summary
To summarize, Differin (adapalene) is very minimally absorbed by the body when applied topically. The majority of individuals using the medication in quantities of 1 gram or less per day had no detective levels of the medication in analyzed blood plasma samples.
However, It is not known if Differin passes into the breast milk in appreciable quantities and there is no data available in regard to if, or how much, Differin is excreted in the breast milk. If you are breastfeeding, please speak with your doctor regarding possible use of Differin. At the very least, it is important to not apply Differin to the nipple or chest area prior to breastfeeding to avoid direct contact with your infant.
