فوروسيميد

Diuretic drug with action on the Henle's loop of the nephron. Indicated in the treatment of edema secondary to heart failure, hepatic or renal disease and in the treatment of hypertension. Oral or parenteral administration once or twice a day.

Although the manufacturer says that it is excreted in the mother's milk ^{(Cinfa 2018, Sanofi 2018)}, at latest update, relevant published data on excretion into breast milk were not found.

Its high protein-binding capacity and short acting (short half-life) make excretion into breast milk in significant amount unlikely. ^{(Kearney 2018)}

Because of a low oral bioavailability, mostly in the neonatal period ^{(Kearney 2018)}, absorption from the ingested milk is thought to be minimal.

No problems have been observed in infants whose mothers have taken Furosemide ^{(Anderson 2018 & 2016, Soussan 2014, Anderson 2003, Ito 1993)}. No breastfeeding problems have been observed in mothers treated with furosemide in the first few days immediately postpartum. ^{(Lopes 2021)}

Authorized use in the neonatal period.

Anecdotally and poorly proven, furosemide was used along with water restriction for inhibition of lactation ^{(Cominos 1976)}. Furosemide does not reduce prolactin levels ^{(Kalk 1977)}. Despite some older studies, there is no scientific evidence that diuretics reduce breast milk production. ^{(Rowe 2013)}

In 2018, a mother reported decreased milk production after the seventh day of treatment (Annotated in "Help us improve this entry").

Several medical societies, experts and expert consensus, consider the use of this medication safe or probably safe during breastfeeding. ^{(Briggs 2015, Hale 2017 p 409, Kearney 2018, Malachias 2016, Schaefer 2007 p691)}

Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable.

Long-term treatment with diuretic drugs, particularly Thiazides with long-lasting effect and action on the Henle's loop, 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.