Is Atenolol compatible with breastfeeding? Do we have alternatives for Atenolol?


August 30, 2018 (High Risk)

A cardioselective beta-blocker used in the treatment of high blood pressure (HBP), angina pectoris, myocardial infarction, cardiac arrhythmias and in the prophylaxis of migraine.
Oral administration once a day.

It is excreted in breastmilk in varying quantities but which could be clinically significant (Lwin 2018, Eyal 2010, Hebert 2005, Schmimmel 1989, Atkinson 1988, Kulas 1984, Thorley 1983).

Varying levels have been measured in the plasma or urine of infants whose mothers were taking it (Schmimmel 1989, Fowler 1984, Thorley 1983, Liedholm 1982 and 1981), although some authors have not found detectable levels in the plasma or urine of infants (Eyal 2010, Kulas 1984, White 1984).

No problems have been observed in infants whose mothers were taking this medication (Eyal 2010, Kulas 1984, White 1984, Fowler 1984, Thorley 1983, Liedholm 1982) except for a newborn who, at 5 days of age, presented bradycardia, cyanosis and hypothermia; the mother was taking 50 mg/12 hours of atenolol for postpartum hypertension; the symptoms disappeared when the mother discontinued the medication (Schmimmel 1989).

Hyperprolactinemia and galactorrhea have been observed with the use of atenolol (Lee 1982).

Within the same group, there are drugs with a safer pharmacokinetic profile for breastfeeding (higher protein binding, shorter half-life and lower oral bioavailability: Tamargo 2011, Riant 1986) and that are known not to cause problems during breastfeeding (Anderson 2018).

Safer alternatives are preferred during breastfeeding, especially during the neonatal period and in case of prematurity (Lwin 2018, Malachias 2016, Davanzo 2014, Hutchinson 2013, Rowe 2013, Ghanem 2008, Hale 2003, WHO 2002, Shannon 2000).


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.


  • أتينولول (Arabic)
  • Атенолол (Cyrillic)
  • 阿替洛尔 (Chinese)
  • アテノロール (Japanese)
  • Aténolol (French)
  • C14 H22 N2 O3 (Molecular formula)
  • 2-{p-[2-Hydroxy-3-(isopropylamino)propoxy]phenyl}acetamide (Chemical name)
  • C07AB03 (ATC Code/s)


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  2. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018Abstract
  3. 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)
  4. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014Abstract
  5. Hutchinson S, Marmura MJ, Calhoun A, Lucas S, Silberstein S, Peterlin BL. Use of common migraine treatments in breast-feeding women: a summary of recommendations. Headache. 2013Abstract Full text (link to original source) Full text (in our servers)
  6. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  7. Tamargo Menéndez J, Delpón Mosquera E. Farmacología de los bloqueantes de los receptores β-adrenérgicos. Curso βeta 2011 de Actualización en Betabloqueantes. 2011 Full text (in our servers)
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  12. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
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