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I have a tumor on my adrenal gland and have to take both alpha and beta blockers prior to surgery to keep my blood pressure from spiking. I am already on beta blockers that I have been told are safe for breastfeeding but there is less information on the alpha blockers. I would be prescribed Phenoxybenzamine or doxazosin most likely. Is it possible that either of these is safe to take while breastfeeding? My son is only 3 months so I would like to continue to nurse him.
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Beta Blockers are OK as long as you avoid Acebutolol and atenolol. Metoprolol is ideal for breastfeeding.
Here is data on Doxazosin. Probably safe. Doxazosin mesylate is an alpha-1 adrenergic receptor blocker indicated for use in hypertension. In a case report of a single patient (58 kg) who received 4 mg daily for 2 days, the average and maximum milk concentrations were 2.9 and 4.2 µg/L.[1] The authors suggest this provides a relative infant dose of 0.06% and 0.09%, respectively. Our relative infant dose calculations based on these milk concentrations were slightly higher, 0.58%-0.87%.
Phenoxybenzamine is problematic as we have absolutely NO data on this drug in breastfeeding, AND it has a 24 hour half life, so it could be a problem for some days after last usage.
I'd suggest you pump and discard for a few days AFTER the use of these two alpha antagonists, just to be sure.
Good luck
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Tom Hale Ph.D.
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