Bisoprolol use while Breastfeeding
Drugs containing Bisoprolol: Ziac, Zebeta
Bisoprolol Levels and Effects while Breastfeeding
Summary of Use during Lactation
Because there is little published experience with bisoprolol during breastfeeding and potentially extensive excretion into breastmilk, other agents may be preferred, especially while nursing a newborn or preterm infant.
The excretion of beta-adrenergic blocking drugs into breastmilk is largely determined by their protein binding. Those with low binding are more extensively excreted into breastmilk. Accumulation of the drugs in the infant is related to the fraction excreted in urine. With 30% protein binding, 50% renal excretion and a moderately long half-life, bisoprolol presents a moderately high risk for accumulation in infants, especially neonates.
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
A study of mothers taking beta-blockers during nursing found a numerically, but not statistically significant increased number of adverse reactions in those taking any beta-blocker. Although the ages of infants were matched to control infants, the ages of the affected infants were not stated. None of the mothers were taking bisoprolol. Beta-adrenergic blocking drugs with breastmilk excretion characteristics similar to bisoprolol's have caused adverse effects in breastfed newborns.
Possible Effects on Lactation
Relevant published information on the effects of beta-blockade or bisoprolol during normal lactation was not found as of the revision date. A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol.
Alternate Drugs to Consider
1. Riant P, Urien S, Albengres E et al. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986;35:4579-81. PMID: 2878668
2. Ho TK, Moretti ME, Schaeffer JK et al. Maternal beta-blocker usage and breast feeding in the neonate. Pediatr Res. 1999;45:67A. Abstract 385.
3. Boutroy MJ, Bianchetti G, Dubruc C, et al. To nurse when receiving acebutolol: is it dangerous for the neonate? Eur J Clin Pharmacol. 1986;30:737-9. PMID: 3770068
4. Schimmel MS, Eidelman AI, Wilschanski MA et al. Toxic effects of atenolol consumed during breast feeding. J Pediatr. 1989;114:476-8. PMID: 2921694
5. Board JA, Fierro RJ, Wasserman AJ et al. Effects of alpha- and beta-adrenergic blocking agents on serum prolactin levels in women with hyperprolactinemia and galactorrhea. Am J Obstet Gynecol. 1977;127:285-7. PMID: 556882
CAS Registry Number
- Antihypertensive Agents
- Adrenergic Beta-Antagonists
LactMed Record Number
Information from the National Library of Medicine's LactMed Database.
Last Revision Date
Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.