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I'm a heart failure patient (idiopathic dilated CMO) and I've been breastfeeding my toddler (2 1/2 years old) while taking enalapril 5mg BID and carvedilol 25mg BID as my GDMT meds, no diuretics. I'm slowly becoming intolerant to the ACE-I and it's not currently the gold standard for treatment anymore. My cardiologist would like to change me to Entresto 49/51mg BID and add an SGLT2i (Farxiga) at some point. The carvedilol will likely remain the same or decreased depending on blood pressure response. I haven't been able to find much data about the use of these meds singularly or in tandem in a healthy breastfeeding toddler. She only nurses at night to fall asleep and then briefly in the morning upon waking.
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There are no data on the transfer of Entresto into human milk. This product is relatively hazardous and is not a good choice to use in a breastfeeding mother. At this time it is rated an L-4 Possibly Hazardous as it can cause hypotension, solemness, difficulty waking, and sedation in the baby. We would not recommend to breastfeed while taking this.
Alicia Nelson RN
Infant Risk Center -
Hello there!
As Alicia mentioned, we historically believed that Entresto is not compatible with breastfeeding. However, we have will be publishing data soon on the transfer of sacubitril and valsartan (Entresto) into breastmilk - milk concentrations for both drugs are VERY low. Considering this, I sincerely doubt that a breastfeeding toddler would have any issues from drug exposure via breastmilk.
We don't have any data on Farxiga, but are collecting milk samples from mothers who are taking it.
Dr. KrutschComment
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