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Amlodipine risk

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  • Amlodipine risk

    My essential hypertension was controlled throughout my pregnancy and first 6 months postpartum with increasing doses of labetalol (current dosage 400mg 2x a day) . However my BP is once again high and have added a 5 mg dose of Amlodipine. My 6 month old infant has been roughly 1/2 formula and 1/2 breastfed baby and my pediatrician recommended I stop breastfeeding completely due to unknown effects of amlodipine and passage into breastmilk. Ideally I would still like to breastfeed my child for 2-3 feedings per day but is it safe? Does the potential benefit of breastfeeding outweigh risk of unknown effect of amlodipine on infant?

  • #2

    Amlodipine is rated an L3-limited data-probably compatible. The amount that transfers into breast milk is 1.72-3.15% of your dose. The normal dose of amlodipine is 5-10mg a day. "Although the case reports and one quantification study support the prospect of low levels of amlodipine in breastmilk, the pharmacokinetics, estimated RID and clinical experience with nifedipine make it the preferred calcium channel blocker in lactation. The use of this product should not deter a woman from breastfeeding if this medication is required." (Medications and Mothers' Milk database, Dr Thomas Hale PhD). Your infant is a little older, and the fact that the baby is already receiving half breast milk and half formula reduces the risk of side effects in your infant. We think it is probably ok to nurse your infant as long as the baby is not symptomatic. Monitor for drowsiness, lethargy, pallor, poor feeding and weight gain.

    Sandra Lovato R.N.
    InfantRisk Center