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UK
Drugs in Lactation Advisory Service
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Anti-asthma
Agents
- Individual
maternal and infant situations must be taken into account before any
drug is prescribed for the mother.
- In
general, all drugs should be avoided in premature or low birth weight
infants, or in those who have any underlying conditions.
- If
a drug is prescribed, it should be at the lowest practical dose and
for the shortest time.
|
Drugs
|
Suitability
for use in lactation
|
Comments
|
|
Preferred
route of administration is via inhalation which reduces systemic
absorption and drug passage into breast milk.
Prefer
agent for which data on use in lactation available
|
| Beta
agonists |
Terbutaline |
Yes
|
Low
levels in milk after oral maternal dosing |
| |
Salbutamol |
?
|
No
published clinical data on excretion into breast milk. Inhalation
route considered safe |
| |
Other
agents |
?
|
No
data available |
| Antimuscarinic
agents |
Ipratropium
Oxitropium
|
?
|
No
data available.
Theoretical
considerations suggest minimal passage into breast milk. Inhalation
route considered safe
|
| Xanthines |
Theophylline |
Yes
|
Single
report of infant irritability and fretful sleeping. Oral preparations
considered safe if maternal plasma levels well controlled. Avoid exposure
of premature infants because of prolonged half life and risk of drug
accumulation. Caution in neonates. |
| Leukotriene
antagonists |
Montelukast |
?
|
No
clinical data. Animal studies suggest passage into breast milk. |
| Corticosteroids |
Prednisolone
(doses up to 50mg daily) |
Yes
|
Low
levels in milk. Inhaled route preferred |
| Miscellaneous |
Cromoglycate |
Yes
|
No
clinical data. Theoretical considerations suggest minimal passage
into breast milk. Minimal absorption from gastrointestinal tract. |
Drugs
classified with '?' should be used with caution and only after an assessment
of benefit to the mother versus risk, real or potential, to the infant.
These drugs either have insufficient clinical data on their use in lactation
to regard as absolutely safe or they have had minor, reversible side effects
reported in a breast-fed infant.
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