Last update Feb. 10, 2019
We do not have alternatives for Cyclopentolate Hydrochloride.
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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A tertiary amine with a muscarinic effect similar to atropine, used in the form of eye drops for pupil dilation (Akorn 2017, Alcon 2017)
Since the last update we have not found published data on its excretion in breastmilk.
There have been reports of serious side effects after ophthalmic administration in children (seizure in a premature baby girl: Büyükcam 2012).
A recent publication reports fewer side effects than atropine (Wakayama 2018)
Because of its anticholinergic effect it can inhibit the secretion of prolactin (Bizzarro 1980, Evans 1985) and reduce the production of milk during the first weeks after childbirth. When breastfeeding is well established, milk production depends less on the levels of prolactin.
The small dose and the low plasma absorption of most topical ophthalmological preparations make it unlikely it will transfer to breastmilk in significant amounts.
After its ophthalmic administration, plasma concentrations of cyclopentolate are in the order of few nanograms per millilitre and are about 3,000 times lower than ophthalmic concentrations (Hale 2017 p 238, Alcon 2017).
Use the minimum dose and concentration possible and press a finger on the conjunctival sac for 2 minutes, removing the excess with a clean cloth, in order to avoid systemic absorption.