Is Amlodipine Besylate compatible with breastfeeding? Do we have alternatives for Amlodipine Besylate?

Amlodipine Besylate

May 3, 2018 (Low Risk)

It is excreted into breast milk in low (Naito 2015) or undetectable concentration (Morgan 2018), without problems observed in infants whose mothers were on treatment with this drug. (Naito 2015, Szucs 2010, Ahn 2007).
When measured, the plasma levels of drug in these infants were undetectable (Morgan 2018, Vasa 2013 S15-poster 29).

Because its drug elimination period is very prolonged, safer known alternatives may be preferable, especially during the neonatal period and in case of premature infant.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • Αμλοδιπίνη βεσυλική (Greek)
  • أملوديبين (Arabic)
  • Амлодипин (Cyrillic)
  • 氨氯地平 (Chinese)
  • アムロジピン (Japanese)
  • C20 H25 ClN2 O5, C6 H6 O3 S (Molecular formula)
  • C08CA01 (ATC Code/s)

References

  1. Morgan JL, Kogutt BK, Meek C, Stehel EK, McIntire DD, Sheffield JS, Roberts SW. Pharmacokinetics of amlodipine besylate at delivery and during lactation. Pregnancy Hypertens. 2018Abstract
  2. Malachias MV, Figueiredo CE, Sass N, Antonello IC, Torloni MR, Bortolotto MRF L. 7th Brazilian Guideline of Arterial Hypertension: Chapter 9 - Arterial Hypertension in pregnancy Arq Bras Cardiol. 2016Abstract Full text (link to original source) Full text (in our servers)
  3. Naito T, Kubono N, Deguchi S, Sugihara M, Itoh H, Kanayama N, Kawakami J. Amlodipine passage into breast milk in lactating women with pregnancy-induced hypertension and its estimation of infant risk for breastfeeding. J Hum Lact. 2015Abstract
  4. Vasa R, Martha Ramirez M. Amlodipine exposure through breastfeeding in a 32 week preterm newborn. Breastfeeding Med. 2013;8 (Suppl 1):S15. Breastfeeding Med; 8 (Suppl 1):S15. 2013 Full text (link to original source) Full text (in our servers)
  5. Amlodipine Data Sheet 2013 Full text (in our servers)
  6. Szucs KA, Axline SE, Rosenman MB. Maternal membranous glomerulonephritis and successful exclusive breastfeeding. Breastfeed Med. 2010Abstract
  7. Ahn HK, Nava-Ocampo AA, Han JY, Choi JS, Chung JH, Yang JH, Koong MK, Park CT. Exposure to amlodipine in the first trimester of pregnancy and during breastfeeding. Hypertens Pregnancy. 2007Abstract
  8. Amlodipino Ficha técnica 2007 Full text (in our servers)
  9. Meredith PA, Elliott HL. Clinical pharmacokinetics of amlodipine. Clin Pharmacokinet. 1992Abstract