No announcement yet.

Breastfeeding with glaucoma

  • Filter
  • Time
  • Show
Clear All
new posts

  • Breastfeeding with glaucoma

    I'm currently 23 weeks pregnant and have Iridocorneal Endothelial Syndrome (ICE) syndrome. I take Alphagan P 0.1% (brimonidine) 3 times a day and Cosopt PF 0.5% (dorzolamide) 1 time per day to manage my glaucoma and high eye pressure. I'd like to breastfeed if possible while continuing to take these eye drops. Do you have studies or research that show the safety of continuing them during breastfeeding?

  • #2

    The dorzolamide is probably ok, it is rated and L3-no data-probably compatible. "We do not have data on transfer to milk, but because plasma levels are incredibly low, levels in milk are probably low to undetectable. Do not use in mothers with infants who have poor creatinine clearance, such as premature infants. Risk level with this product is probably quite low." (Medications and Mothers' Milk database, Dr Thomas Hale). If your baby is born term and without complications this eye drop is probably safe to use while breastfeeding. To reduce exposure of eye drops we recommend applying pressure at the tear duct for 1 minute after applying the drops.

    The brimonidine is questionable, it is rated an L3- no data-probably compatible. Here is our information: "No data are available on the transfer of brimonidine into human milk. Pharmacokinetic properties suggest the potential for significant transfer into breastmilk. However, the degree of systemic absorption is not well established and may be variable from patient to patient. There are no data on oral bioavailability in adults or babies." (Medications and Mothers' Milk database, Dr Thomas Hale). Eye drops generally have low systemic absorption, but this medication appears to vary in different individuals. Lexicomp database reads as follows : " It is not known if brimonidine is excreted in breast milk. Due to the potential for serious adverse reactions in the nursing infant, the manufacturer recommends a decision be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of treatment to the mother." I would recommend discussing this with your Dr and your child's pediatrician and making an informed decision from those discussions. If you decide to breastfeed we still recommend applying pressure at the tear duct to reduce exposure for 1 minute and to monitor your infant for drowsiness, not waking to feed, dry mouth.

    Sandra Lovato R.N.
    InfantRisk Center


    • #3
      Thank you for your help! Would you recommend waiting a certain amount of time after taking the drop before breastfeeding? Would that help decrease the amount of the eye drop that could be transferred in the milk?