Last update May 16, 2019
An amine antimuscarinic with anticholinergic effects similar to atropine.
Indicated in occasional use to achieve mydriatic and/or cycloplegic effects in ophthalmic examinations.
Topical administration in the form of eye drops.
Since the last update we have not found any published data on its excretion in breast milk.
It reaches small plasma concentrations and its rapid elimination (AEMPS 2017, Vuori 1994) makes transfer into breastmilk in significant quantities very unlikely and, if you wish to minimize the already unlikely exposure, there should be a delay of two hours after administration before breastfeeding again.
The small dose and poor plasma absorption of most topical ophthalmic preparations make it unlikely that significant amounts will transfer into breastmilk.
Systemic absorption can be minimized by pressing on the tear duct (inner canthus of the eye) with a finger for 1-2 minutes (Bausch 2018).
Drugs with an anticholinergic/antimuscarinic effects can inhibit prolactin secretion (Masala 1982), but stimulation by infant suckling is usually sufficient to ensure the production of breastmilk (Messinis 1985).
Decreased production of breastmilk has not been reported with usual doses of antimuscarinic eye drops.
We do not have alternatives for Bistropamide.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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e-lactancia is a resource recommended by Asociación Española de Bancos de Leche Humana of Spain
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