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

Digoxin

May 13, 2018 (Very Low Risk)

It is excreted in breast milk in clinically insignificant amounts (AEMPS 2013, GSK 2009, Tan 2001, Reinhardt 1982, Finley 1979, Loughnan 1978, Chan 1978, Levy 1977) and no problems have been observed in infants whose mothers were taking it (Miller 1986 , Finley 1979, Loughnan 1978).
The plasma levels of these infants were undetectable or very low (Tan 2001, Reinhardt 1982, Finley 1979, Loughnan 1978).

List of essential WHO medications: compatible with breastfeeding (WHO/ UNICEF, 2002). American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

Alternatives

We do not have alternatives for Digoxin since it is relatively safe.

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

  • Διγοξίνη (Greek)
  • ديغوكسين (Arabic)
  • Дигоксин (Cyrillic)
  • 地高辛 (Chinese)
  • ジゴキシン (Japanese)
  • Digoxine (French)
  • C41 H64 O14 (Molecular formula)
  • 3β-[(O-2,6-Dideoxy-β-d-ribo-hexopyranosyl-(1→4)-O-2,6-dideoxy-β-d-ribo-hexopyranosyl-(1→4)-2,6-dideoxy-β-d-ribo-hexopyranosyl)oxy]-12β,14β-dihydroxy-5β-card-20(22)-enolide (Chemical name)
  • C01AA05 (ATC Code/s)

Drug trade names

References

  1. 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)
  2. Tan HL, Lie KI. Treatment of tachyarrhythmias during pregnancy and lactation. Eur Heart J. 2001Abstract Full text (link to original source) Full text (in our servers)
  3. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  4. Miller MR, Withers R, Bhamra R, Holt DW. Verapamil and breast-feeding. Eur J Clin Pharmacol. 1986Abstract
  5. Reinhardt D, Richter O, Genz T, Potthoff S. Kinetics of the translactal passage of digoxin from breast feeding mothers to their infants. Eur J Pediatr. 1982Abstract
  6. Finley JP, Waxman MB, Wong PY, Lickrish GM. Digoxin excretion in human milk. J Pediatr. 1979Abstract
  7. Loughnan PM. Digoxin excretion in human breast milk. J Pediatr. 1978Abstract
  8. Chan V, Tse TF, Wong V. Transfer of digoxin across the placenta and into breast milk. Br J Obstet Gynaecol. 1978Abstract
  9. Levy M, Granit L, Laufer N. Excretion of drugs in human milk. N Engl J Med. 1977Abstract