Diltiazem Hydrochloride
It is excreted in breast milk in a clinically non-significant amount (Okada 85)
Two 6 months-old breastfed twins whose mother was treated with diltiazem did not get into health problems (Lubbe 87)
Evidence on other antihypertensive drugs of the same family with similar structure, pharmacokinetics and action profile (nifedipine, nimodipine, nicardipine) has shown that they are excreted into milk in non-significant amount.
Diltiazem does not have any influence on prolactin production.
Until more extensive published data about this drug regarding breastfeeding are available a safer alternative drug should be used, especially during the neonatal period and/or in case of premature infants.
American Academy of Pediatrics: medication usually compatible with breastfeeding.
Alternatives
- Nimodipine (Very Low Risk)
- Nifedipine (Very Low Risk)
- Verapamil Hydrochloride (Very Low Risk)
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
- Διλτιαζέμη υδροχλωρική (Greek)
- Дилтиазема Гидрохлорид (Cyrillic)
- ジルチアゼム塩酸塩 (Japanese)
- C22H26N2O4S,HCl (Molecular formula)
Drug trade names
- Acalix™
- Altiazem (Алтиазем)™
- Angiotrofin™
- Apo-Diltiaz™
- Cal-Antagon™ (Portugal)
- Cardil (Кардил)™
- Cardil™
- Cardiser™
- Cardizem™
- Cartia™
- Corodrox™
- Cronodine™
- Dilaclan™
- Dilfar™
- Diltiaz™
- Diltiwas™
- Diltizem™
- Dilzem™
- Dinisor™
- Doclis™
- Elvesil™
- Incoril™
- Lacerol™
- Ling Shuang (灵爽)™
- Masdil™
- Mavitalon™
- Mono-Tildiem (蒂尔丁)™
- Mono-Tildiem™
- Presoquin™
- Tiazac™
- Tilazem™
- Tildiem™
- Tilker™
References
- Serrano Aguayo P, García de Quirós Muñoz JM, Bretón Lesmes I, Cózar León MV. Tratamiento de enfermedades endocrinológicas durante la lactancia. [Endocrinologic diseases management during breastfeeding.] Med Clin (Barc). 2015Abstract
- Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
- Velardo A, Ricci S, Zironi C, Pantaleoni M, Zizzo G, Badiali A, Marrama P. Effects of prolonged treatment with diltiazem on pituitary secretion of luteinizing hormone, follicle-stimulating hormone, thyrotropin and prolactin. Horm Res. 1992Abstract
- Lubbe WF. Use of diltiazem during pregnancy. N Z Med J. 1987Abstract
- Okada M, Inoue H, Nakamura Y, Kishimoto M, Suzuki T. Excretion of diltiazem in human milk. N Engl J Med. 1985Abstract
- Hermann P, Rodger SD, Remones G, Thenot JP, London DR, Morselli PL. Pharmacokinetics of diltiazem after intravenous and oral administration. Eur J Clin Pharmacol. 1983Abstract