Gentian Violet

Drug Levels and Effects:




Summary of Use during Lactation:


Gentian violet (crystal violet) was used in the past to treat oral and nipple thrush during breastfeeding. Gentian violet is potentially toxic to the mucous membranes, causing ulceration,[1][2][3][4] and potentially tattooing the skin. It can also interact with DNA[5], is carcinogenic and mutagenic in rodents, and occasionally causes allergic sensitization, with cross reactions to other triphenylmethane dyes.[6] Its use has been severely curtailed by authorities in England and Australia.[7][8] It is also very messy, staining skin and clothing. A 2001 survey of the members of the Academy of Breastfeeding Medicine found that gentian violet is rarely (1 to 2% of respondents) used by breastfeeding experts for initial treatment of oral thrush and is very infrequently (3 to 4% of respondents) used for recurrent or persistent thrush.[9] The use of gentian violet should be avoided topically on the nipples or in the infant's mouth; safer alternatives for treating thrush are available.[10]


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:


Gentian violet has caused oral ulceration in breastfed infants treated with 1% or 2%solutionapplied to the mouth and tongue for thrush.[1][2][3]

A 2-week-old exclusively breastfed infant was treated for oral thrush with aqueous 1% gentian violetsolutiontwice daily for 1 day. The parents discontinued it because they thought it was causing airway discomfort. After 2 days, it was restarted at 4 times a day. Cough and difficulty feeding developed after 1 day and the infant was then admitted to the hospital, ultimately requiring intubation.[4]


Possible Effects on Lactation:


Relevant published information was not found as of the revision date.


Alternate Drugs to Consider:


Clotrimazole,Fluconazole,Miconazole,Nystatin


References:


1. Bjornberg A, Mobacken H. Necrotic skin reactions caused by 1 per cent gentian violet and brilliant green. Acta Derm Venereol. 1972;52:55-60. PMID:4111108
2. Utter AR. Gentian violet treatment for thrush: can its use cause breastfeeding problems. J Hum Lact. 1990;6:178-80. Letter. PMID:2271112
3. Utter AR. Gentian violet and thrush. J Hum Lact. 1992;8:6. Letter. PMID:1558661
4. Baca D, Drexler C, Cullen E. Obstructive laryngotracheitis secondary to gentian violet exposure. Clin Pediatr (Phila). 2001;40:233-5. PMID:11336425
5. Rosenkranz HS, Carr HS. Possible hazard in use of gentian violet. Br Med J. 1971;3:702-3. Letter. PMID:5569557
6. Bielicky T, Novak M. Contact-group sensitization to triphenylmethane dyes. Gentian violet, brilliant green, and malachite green. Arch Dermatol. 1969;100:540-3. PMID:5350405
7. Phillips V. Is gentian violet safe? J Hum Lact. 1993;9:7-8. PMID:8489730
8. Hoppe JE. Treatment of oropharyngeal candidiasis and candidal diaper dermatitis in neonates and infants: review and reappraisal. Pediatr Infect Dis J. 1997;16:885-94. PMID:9306485
9. Brent NB. Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment. Clin Pediatr (Phila). 2001;40:503-6. PMID:11583049
10. Stoukides C. Topical medications and breastfeeding. J Hum Lact. 1993;9:185-6. PMID:8260040



Substance Identification:




Substance Name:

Gentian Violet

CAS Registry Number:

548-62-9

Drug Class:


  • Anti-Infective Agents, Local


  • Administrative Information:




    LactMed Record Number:


    951


    Last Revision Date:


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