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

Hydrochlorothiazide

February 20, 2015 (Very Low Risk)

Thiazide diuretic drug.

Excretion into breast milk is clinically non-significant. No side-effects were observed in a one-month old breastfed baby whose mother was treated with this medication. Drug level in the plasma of this child was undetectable.

Long-term treatment with diuretic drugs (particularly Thiazide type ones with long-lasting effect and loop-acting mechanism) may inhibit lactation, mostly if lactation is not well-established yet. Use as lower dose as possible, especially during the first postnatal month.

American Academy of Pediatrics 2013: Maternal Medication Usually Compatible With Breastfeeding.

WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Alternatives

We do not have alternatives for Hydrochlorothiazide 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.

Synonyms

  • ヒドロクロロチアジド
  • هيدروكلوروثيازيد
  • Гидрохлоротиазид
  • 氢氯噻嗪

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. KF. Hidroclorotiazida. Ficha técnica. 2009 Full text (in our servers)
  5. 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)
  6. 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)
  7. 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)
  8. Kirsten R, Nelson K, Kirsten D, Heintz B. Clinical pharmacokinetics of vasodilators. Part II. Clin Pharmacokinet. 1998Abstract
  9. Miller ME, Cohn RD, Burghart PH. Hydrochlorothiazide disposition in a mother and her breast-fed infant. J Pediatr. 1982Abstract
  10. Papadimitriou G, Rummel W. [Prevention or inhibition of lactation with hydrochlorothiazide]. Geburtshilfe Frauenheilkd. 1966Abstract
  11. BARTH L. HYDROCHLOROTHIAZIDE FOR POSTPARTUM BREAST ENGORGEMENT. J Med Soc N J. 1963Abstract
  12. Stout G. Suppression of lactation. Br Med J. 1962;1:1150. 1962 Full text (link to original source) Full text (in our servers)