Last update: May 11, 2019
Poorly safe. Evaluate carefully.
Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives).
Read the Comment.
A centrally and peripherally-acting alpha-1 adrenergic antagonist with vasodilator effect indicated in the treatment of hypertensive crises. Administration via intravenous infusion for a maximum of one week.
Since the last update we have not found any published data on its excretion in breast milk.
Its pharmacokinetic data (Kirsten 1998 and 1988) makes it difficult to accurately predict its possible excretion in breastmilk.
Pharmacokinetics show that after 3 elimination half-lives (T½) 87.5% of the drug is eliminated from the body; after 4 T½ it is 94%, after 5 T½, 96.9%, after 6 T½, 98.4% and after 7 T½ it is 99%. From 7 T½ the plasmatic concentrations of drug in the body are negligible. In general, a period of at least five half-lives can be considered a safe waiting period before breastfeeding again (Anderson 2016).
Taking as reference the longest published T½ (Kirsten 1988) these 5 T½ would correspond to 24 hours.
To further minimize the risk it may be advisable to stop breastfeeding until 35 hours after the last dose (7 T½).
Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable (Kutlesič 2015, Schaefer 2007 p685), especially during the neonatal period and in cases of prematurity.
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.
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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine from United States of America
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