Heart Medications

[kmcconaghy]

I am breastfeeding a 16-month-old and have recently been diagnosed with a heart condition. My provider was looking at the following medications but was unsure what I could take while breastfeeding:

- Metoprolol succinate
- Entresto (sacubitril/valsartan)
- Lisinopril
- Losartan
- Valsartan
- Jardiance/Farxiga
- Sprionolactone/Eplerenone

Could you please advise on which of these would be safe for my toddler? Thank you!

[kaytlin]

Hi there—a 16 month old is going to be at fairly low risk, most of their nutrition won’t come from your milk and their ability to metabolize the drug should be good.

I’ll summarize what we know below. Please call our nurses to talk it over if you’d like more info.

- Metoprolol succinate: commonly used when breastfeeding, low transfer
- Entresto (sacubitril/valsartan): we just published data of extremely low levels in milk
- Lisinopril: we have unpublished data of very low levels in milk
- Losartan: no data, probably ok
- Valsartan: not detectable in milk (entresto study). This is the only ARB with lactation data!
- Jardiance/Farxiga: no data, not preferred
- Sprionolactone: low transfer, commonly used
-/Eplerenone: no data, probably ok

Dr. Krutsch