Last update: Nov. 24, 2014

Spironolactone

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

A diuretic which is antagonist of Aldosterone receptor and a potassium-sparing drug.

Excretion into breast milk is clinically non-significant and without side-effects observed in breastfed infants of treated mothers.

A medication which is used for treatment of infants even in the neonatal period.

It decreases slightly the secretion of Prolactin, however, instead other diuretic drugs, a suppressive effect on lactation has not been reported.

The American Academy of Pediatrics (2001) rates it as Medication Usually Compatible With Breastfeeding.

Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Alternatives

We do not have alternatives for Spironolactone 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.

Group

Spironolactone belongs to this group or family:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 90 %
Molecular weight 417 daltons
Protein Binding 90 %
Tmax 1 - 2,6 hours
T1/2 13 - 24 hours
M/P ratio 0,5 - 0,7 -
Theoretical Dose 0,016 mg/Kg/d
Relative Dose 1,9 %
Relat.Ped.Dose 0,5 - 1,6 %

References

  1. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018 Abstract
  2. Kearney L, Wright P, Fhadil S, Thomas M. Postpartum Cardiomyopathy and Considerations for Breastfeeding. Card Fail Rev. 2018 Abstract Full text (link to original source) Full text (in our servers)
  3. 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)
  4. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  5. Nakhjavani M, Hamidi S, Esteghamati A, Abbasi M, Nosratian-Jahromi S, Pasalar P. Short term effects of spironolactone on blood lipid profile: a 3-month study on a cohort of young women with hirsutism. Br J Clin Pharmacol. 2009 Abstract
  6. Ghanem FA, Movahed A. Use of antihypertensive drugs during pregnancy and lactation. Cardiovasc Ther. 2008 Abstract Full text (link to original source) Full text (in our servers)
  7. 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)
  8. 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)
  9. Erenus M, Gürbüz O, Durmuşoğlu F, Demirçay Z, Pekin S. Comparison of the efficacy of spironolactone versus flutamide in the treatment of hirsutism. Fertil Steril. 1994 Abstract
  10. Cusan L, Dupont A, Gomez JL, Tremblay RR, Labrie F. Comparison of flutamide and spironolactone in the treatment of hirsutism: a randomized controlled trial. Fertil Steril. 1994 Abstract
  11. Vĕtr M, Sobek A. Low dose spironolactone in the treatment of female hyperandrogenemia and hirsutism. Acta Univ Palacki Olomuc Fac Med. 1993 Abstract
  12. Phelps DL, Karim A. Spironolactone: relationship between concentrations of dethioacetylated metabolite in human serum and milk. J Pharm Sci. 1977 Abstract

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