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

Formoterol

July 16, 2015 (Very Low Risk)

Bronchodilator of long-lasting action.

At latest update no published data on excretion into breast milk were found.

Terbutaline which is a compound closely related to Formoterol is excreted into breast milk in non-significant amount.
Salmeterol, another compound with similar characteristics, is also non-significantly excreted.
With a relatively high molecular weight, excretion into breast milk seems unlikely.

Expert consensus states that the use of inhaled bronchodilators is compatible with breastfeeding due to a minimal absorption and low levels achieved in the mother's plasma.

Inhaled therapy with bronchodilators is preferred since they use a lower dose (less likelihood of excretion into milk)

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.

Synonyms

  • BD-40A
  • CGP-25827A
  • Eformoterol
  • Formoterol Fumarate
  • YM-08316

Writings

  • Формотерола Фумарат (Cyrillic)
  • フマル酸ホルモテロール (Japanese)
  • (C19 H24 N2 O4)2,C4 H4 O4 (Molecular formula)

Drug trade names

References

  1. National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. Quick Reference from the Working Group Report on Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. 2004;1-12. 2004 Full text (link to original source) Full text (in our servers)
  2. National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. 2004;1-57. 2004 Full text (link to original source) Full text (in our servers)
  3. Cazzola M, Testi R, Matera MG. Clinical pharmacokinetics of salmeterol. Clin Pharmacokinet. 2002Abstract
  4. Nelson-Piercy C. Asthma in pregnancy. Thorax. 2001Abstract Full text (link to original source) Full text (in our servers)
  5. McDonald CF, Burdon JG. Asthma in pregnancy and lactation. A position paper for the Thoracic Society of Australia and New Zealand. Med J Aust. 1996Abstract
  6. Ellsworth A. Pharmacotherapy of asthma while breastfeeding. J Hum Lact. 1994Abstract
  7. Lindberg C, Boréus LO, de Château P, Lindström B, Lönnerholm G, Nyberg L. Transfer of terbutaline into breast milk. Eur J Respir Dis Suppl. 1984Abstract
  8. Lönnerholm G, Lindström B. Terbutaline excretion into breast milk. Br J Clin Pharmacol. 1982Abstract Full text (link to original source) Full text (in our servers)
  9. Boréus LO, de Château PU. Terbutaline in breast milk. Br J Clin Pharmacol. 1982Abstract Full text (link to original source) Full text (in our servers)