Is Vilanterol Trifenatate compatible with breastfeeding? Do we have alternatives for Vilanterol Trifenatate?

Vilanterol Trifenatate

September 19, 2016 (Very Low Risk)

Long-acting bronchodilator with a similar action than Salmeterol.

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

Plasma concentration after having inhaled bronchodilators is very low, so that a significant amount in the breast milk is not expected (Ellsworth 1994, McDonald 1996).
Its low oral bioavailability hinders the passage from ingested milk towards the infant’s plasma, except in preterm babies and immediate neonatal period, which may show an increased intestinal permeability.

Terbutaline, a molecule of the same family, is excreted in insignificant amounts in breast milk (Lindberg 1984).

Inhaled bronchodilators are preferred because of their lower doses (less risk of excretion into milk).

Alternatives

We do not have alternatives for Vilanterol Trifenatate 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

  • Вилантерола Трифенатат (Cyrillic)
  • ビランテロールトリフェナテート (Japanese)
  • C24H33Cl2NO5,C20H16O2 (Molecular formula)

Drug trade names

References

  1. Kelleher DL, Mehta RS, Jean-Francois BM, Preece AF, Blowers J, Crater GD, Thomas P. Safety, tolerability, pharmacodynamics and pharmacokinetics of umeclidinium and vilanterol alone and in combination: a randomized crossover trial. PLoS One. 2012Abstract
  2. Nelson-Piercy C. Asthma in pregnancy. Thorax. 2001Abstract Full text (link to original source) Full text (in our servers)
  3. 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
  4. Ellsworth A. Pharmacotherapy of asthma while breastfeeding. J Hum Lact. 1994Abstract
  5. 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