Metoprolol excretion into breast milk.

Sandström, B; Regårdh, C G

doi:10.1111/j.1365-2125.1980.tb05850.x

Cited by 46 publications

(10 citation statements)

References 6 publications

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“…The b-blockers of choice are metoprolol (RID 1.4%) and propranolol (RID 0.3%), neither of which has been associated with any infant adverse events. 46,47 In addition, labetalol has not been associated with any adverse effects in infants and has a low RID of 0.6%. 48 Although rarely, atenolol and acebutolol have both been associated with infant adverse effects such as cyanosis, tachypnea, bradycardia, hypotension, and low body temperature, and are not preferred agents.…”

Section: Hypertensionmentioning

confidence: 98%

Maternal Medication, Drug Use, and Breastfeeding

Rowe

Baker

Hale

2015

Child and Adolescent Psychiatric Clinics of North America

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Section: Hypertensionmentioning

confidence: 98%

Maternal Medication, Drug Use, and Breastfeeding

Rowe

Baker

Hale

2015

Child and Adolescent Psychiatric Clinics of North America

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“…The levels of guanethidine (Takyi, 1970) and chlorothiazide (Werthmann & Krees, 1972) were probably too small to cause any adverse effects in the nursing infant. Metoprolol, which like nadolol is a weak base, attained levels in breast milk that were on average 3.5 times higher than those in plasma (Sandstrom, 1980). An infant consuming 1 1 of breast milk per day would receive about 2% of the normal daily dose of metoprolol for a hypertensive adult.…”

Section: Resultsmentioning

confidence: 99%

Nadolol in human serum and breast milk.

Devlin¹,

Duchin²,

Fleiss³

1981

Brit J Clinical Pharma

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1 Simultaneous serum and milk samples were collected over a 10-day period from twelve normotensive, lactating subjects who ingested 80 mg nadolol once daily for a period of 5 days. For comparative purposes, serum samples were also collected from seven patients with a history of mild essential hypertension who ingested the same dose of nadolol for a period of 13 days. 2 In lactating subjects, steady-state serum concentrations of nadolol were attained in 3 days. Milk concentrations of nadolol were much higher than serum concentrations starting on Day 3 and throughout the remainder of the study. The mean (+ s.e. mean) steady-state levels of nadolol in milk (356.9 + 40.4 ng/ml) were 4.6 times higher than the mean steady-state levels in serum (77.3 + 6.9 ng/ml). 3 In hypertensive patients, the mean serum concentration of nadolol 24 h after the twelfth dose was 40.3 + 8.2 ng/ml as compared to a mean serum concentration in lactating subjects of 40.7 3.4 ng/ml, 24 h after the fifth dose. Mean serum concentrations in hypertensive patients at 1 and 4 h after the final daily dose were not significantly different from those in lactating subjects. 4 It can be estimated that a 5 kg nursing infant would consume about 2-7% of the daily adult therapeutic dose of nadolol. The data suggest that caution should be exercised in the use of nadolol in lactating patients.

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“…101 As infant plasma concentrations are negligible, use during breastfeeding is not expected to pose a risk to the infant. 115,116 Although symptoms caused by β-blockade (such as brady cardia and hypoglycaemia) have not previously been reported following exposure to propranolol or metoprolol via milk, some authors nevertheless recommend that exposed infants should be closely observed for these signs. 117 Even though such effects perhaps could be an issue in preterm infants or newborns, we consider it unlikely that any such pharmacological effect would arise in a breastfed infant.…”

Section: Ergot Alkaloidsmentioning

confidence: 96%

Pharmacological treatment of migraine during pregnancy and breastfeeding

et al. 2015

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Migraine affects up to 25% of women of reproductive age. In the majority of these women, migraine improves progressively during pregnancy, but symptoms generally recur shortly after delivery. As suboptimally treated migraine in pregnancy could have negative consequences for both mother and fetus, the primary aim of clinicians should be to provide optimal treatment according to stage of pregnancy, while minimising possible risks related to drug therapy. Nonpharmacological approaches are always first-line treatment, and should also be used to complement any required drug treatment. Paracetamol is the preferred drug for acute treatment throughout pregnancy. If paracetamol is not sufficiently effective, sporadic use of sumatriptan can be considered. NSAIDs such as ibuprofen can also be used under certain circumstances, though their intake in the first and third trimesters is associated with specific risks and contraindications. Preventive treatment should only be considered in the most severe cases. In women contemplating pregnancy, counselling is essential to promote a safe and healthy pregnancy and postpartum period for the mother and child, and should involve a dialogue addressing maternal concerns and expectations about drug treatment. This Review summarizes current evidence of the safety of the most common antimigraine medications during pregnancy and breastfeeding, and provides treatment recommendations for use in clinical practice.

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Metoprolol excretion into breast milk.

Cited by 46 publications

References 6 publications

Maternal Medication, Drug Use, and Breastfeeding

Maternal Medication, Drug Use, and Breastfeeding

Nadolol in human serum and breast milk.

Pharmacological treatment of migraine during pregnancy and breastfeeding

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