Last update: May 13, 2019
Minimal risk for breastfeeding and infant.
Thiazide diuretic drug. Indicated in the treatment of hypertension, edema secondary to heart failure, hepatic or renal disease and in the treatment of diabetes insipidus.
Oral administration once a day.
At a dose of 50 mg / day, the excretion into breast milk is clinically non-significant (Miller 1982). No side-effects were observed in a one-month old breastfed baby whose mother was treated with this medication and drug level in the plasma of this child was undetectable (Miller 1982).
Authorized use in newborns and infants.
Treatment with hydrochlorothiazide does not alter prolactin levels (Eldridge 1984).
Despite some older studies (Papadimitriou 1966, Barth 1963, Stout 1962), there is no scientific evidence that diuretics reduce breast milk production (Anderson 2018, Rowe 2013).
Several medical societies, experts and expert consensus, consider the use of this medication safe or probably safe during breastfeeding (Briggs 2017, Hale 2017 p 461, Malachias 2016, Schaefer 2007 p691).
American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding (AAP 2001).
WHO Model List of Essential Drugs 2002: Compatible with breastfeeding (WHO 2002).
Long-term treatment with diuretic drugs may compromise the state of hydration of the nursing mother. Must make an adjustment (decrease) of the dose based on the estimated milk production and monitor milk production.
We do not have alternatives for Hydrochlorothiazide since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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