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

Furosemide

February 8, 2015 (Low Risk)

Diuretic drug with action on the Henle's loop of the nephron.

At latest update, relevant published data on excretion into breast milk were not found.

Its high protein-binding capacity makes excretion into breast milk in significant amount unlikely. Because of a low oral bioavailability, mostly in the neonatal period, absorption from the ingested milk is thought to be minimal.

Long-term treatment with diuretic drugs, particularly Thiazides with long-lasting effect and action on the Henle's loop, may inhibit lactation.

Furosemide has been used along with water restriction for inhibition of lactation. Because of this, diuretic drugs well established as safe should be preferred while breastfeeding, especially during the first post-natal months.

Whenever used, close attention should be paid to milk production.

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

  • フロセミド
  • LB-502
  • فوروسيميد
  • Фуросемид
  • 呋塞米

Drug trade names

References

  1. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 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. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  4. AEMPS. Furosemida. Ficha técnica. 2011 Full text (in our servers)
  5. Furosemide. Drug Summary. 2011 Full text (in our servers)
  6. Ghanem FA, Movahed A. Use of antihypertensive drugs during pregnancy and lactation. Cardiovasc Ther. 2008Abstract Full text (link to original source) Full text (in our servers)
  7. 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)
  8. Waller ES, Hamilton SF, Massarella JW, Sharanevych MA, Smith RV, Yakatan GJ, Doluisio JT. Disposition and absolute bioavailability of furosemide in healthy males. J Pharm Sci. 1982Abstract
  9. Smith DE, Lin ET, Benet LZ. Absorption and disposition of furosemide in healthy volunteers, measured with a metabolite-specific assay. Drug Metab Dispos. 1980Abstract
  10. Kalk WJ, Cominos DC, van der Walt A, van Rooyen AJ. The effect of furosemide on serum prolactin levels in the postpartum period. S Afr Med J. 1977Abstract
  11. Cominos DC, van der Walt A, van Rooyen AJ. Suppression of postpartum lactation with furosemide. S Afr Med J. 1976Abstract