Pregnancy: There are no adequate data from the use of azithromycin in pregnant women. In reproduction toxicity studies in animals, azithromycin was shown to pass the placenta, but no teratogenic effects were observed (see Toxicology: Preclinical safety data under Actions). The safety of azithromycin has not been confirmed with regard to the use of the active substance during pregnancy. Therefore, azithromycin should only be used during pregnancy if the benefit outweighs the risk.
Breastfeeding: Azithromycin has been reported to be secreted into human breast milk, but there are no adequate and well-controlled clinical studies in breastfeeding women that have characterised the pharmacokinetics of azithromycin excretion into human breast milk.
Serious adverse effects of azithromycin on breast-fed infants have not been observed. A decision needs to be made as to whether breast-feeding should be interrupted or whether the azithromycin therapy should be dispensed with or the treatment interrupted. In this context, both the benefits of breast-feeding for the child and the therapeutic benefits for the woman should be taken into account.
Fertility: In fertility studies conducted in rat, reduced pregnancy rates were noted following administration of azithromycin. The relevance of this finding to humans is unknown.
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