Last update: May 13, 2019

Hydrochlorothiazide

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or 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.

Alternatives

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.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Hydrochlorothiazide in other languages or writings:

Group

Hydrochlorothiazide belongs to this group or family:

Tradenames

Main tradenames from several countries containing Hydrochlorothiazide in its composition:

Pharmacokinetics

Variable Value Unit
Bioavailability 50 - 70 %
Molecular weight 297 daltons
Protein Binding 40 - 68 %
VD 4 - 8 l/Kg
pKa 9,09 -
Tmax 2 - 5 hours
T1/2 5 - 15 hours
M/P ratio 0,28 -
Theoretical Dose 0,012 - 0,018 mg/Kg/d
Relative Dose 1,5 - 2,2 %
Relat.Ped.Dose 0,4 - 0,9 %

References

  1. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018 Abstract
  2. Malachias MV, Figueiredo CE, Sass N, Antonello IC, Torloni MR, Bortolotto MRF L. 7th Brazilian Guideline of Arterial Hypertension: Chapter 9 - Arterial Hypertension in pregnancy Arq Bras Cardiol. 2016 Abstract Full text (link to original source) Full text (in our servers)
  3. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  4. KF. Hidroclorotiazida. Ficha técnica. 2009 Full text (in our servers)
  5. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  6. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  7. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  8. Eldridge JC, Strandhoy J, Buckalew VM Jr. Endocrinologic effects of antihypertensive therapy with guanabenz or hydrochlorothiazide. J Cardiovasc Pharmacol. 1984 Abstract
  9. Miller ME, Cohn RD, Burghart PH. Hydrochlorothiazide disposition in a mother and her breast-fed infant. J Pediatr. 1982 Abstract
  10. Papadimitriou G, Rummel W. [Prevention or inhibition of lactation with hydrochlorothiazide]. Geburtshilfe Frauenheilkd. 1966 Abstract
  11. BARTH L. HYDROCHLOROTHIAZIDE FOR POSTPARTUM BREAST ENGORGEMENT. J Med Soc N J. 1963 Abstract
  12. Stout G. Suppression of lactation. Br Med J. 1962;1:1150. 1962 Full text (link to original source) Full text (in our servers)

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