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Hydrochlorothiazide use while Breastfeeding

Drugs containing Hydrochlorothiazide: Hyzaar, Dyazide, Tribenzor, Ziac, Maxzide, Diovan HCT, Zestoretic, Benicar HCT, Avalide, HydroDIURIL, Show all 78 »Microzide, Prinzide, Aldactazide, Micardis HCT, Exforge HCT, Oretic, Accuretic, Maxzide-25, Vaseretic, Moduretic, Atacand HCT, Esidrix, Lotensin HCT, Dutoprol, Lopressor HCT, Amturnide, Apresazide, Uniretic, Tekturna HCT, Diuretic Ap-Es, Moduretic 5-50, Aldoril, Capozide 50/25, Aquazide H, HydrALAZINE Plus, Carozide, Vaseretic 10-25, Hydroserpine, Ezide, Serpex, Capozide, Capozide 50/15, Serpazide, Teveten HCT, Monopril HCT, Hydra-Zide, Inderide, Hydroserpine 1, Hydroserp, Timolide, Timolide 10-25, Hydro-Reserp, Hydropres-50, Quinaretic, Hydropres-25, Inderide LA, Hydro Par, Vaseretic 5-12.5, Esimil, Ser-Ap-Es, Uni Serp, Oreticyl Forte, Oreticyl 50, Capozide 25/15, Capozide 25/25, Oreticyl 25, Tri-Hydroserpine, Marpres, Loqua, Aldoril 15, Aldoril 25, Aldoril D30, Diaqua, HHR, Hydrap-ES, Serathide, Unipres, Aldoril D50

Hydrochlorothiazide Levels and Effects while Breastfeeding

Summary of Use during Lactation

Hydrochlorothiazide doses of 50 mg daily or less are acceptable during lactation. Intense diuresis with large doses may decrease breastmilk production.

Drug Levels

Maternal Levels. In a mother who was 28 days postpartum, hydrochlorothiazide reached a peak milk level of about 275 mcg/L at about 3 hours after a 50 mg oral dose. The infant received a daily dosage of about 2% of the mother's weight-adjusted dose.[1]

Infant Levels. Hydrochlorothiazide was not detectable (<20 mcg/L) in the serum of a 28-day-old breastfed infant at about 2 and 11 hours after the mother's dose.[1]

Effects in Breastfed Infants

No electrolyte abnormalities were noted in one 28-day-old infant who was breastfed since birth while his mother was taking oral hydrochlorothiazide 50 mg daily.[1]

Effects on Lactation and Breastmilk

Hydrochlorothiazide 100 mg daily in the morning and 50 mg in the afternoon (duration unspecified) has been used to successfully to suppress lactation at various times postpartum.[2] Intense diuresis with thiazides and thiazide-like diuretics, fluid restriction and breast binding have been used to suppress postpartum lactation.[2][3][4] The added contribution of the diuretic to these measures, which are effective in suppressing lactation, has not been studied. There are no data on the effects of diuretics on established, ongoing lactation.

Alternate Drugs to Consider

Chlorothiazide

References

1. Miller ME, Cohn RD, Burghart PH. Hydrochlorothiazide disposition in a mother and her breast-fed infant. J Pediatr. 1982;101:789-91. PMID: 7131161

2. Stout G. Suppression of lactation. Br Med J. 1962;1:1150. Letter. PMC: PMC1958377

3. Healy M. Suppressing lactation with oral diuretics. Lancet. 1961;277:1353-4.

4. Reiher KH. [Suppression of lactation by stimulation of diuresis] . Zentralbl Gynakol. 1963;85:188-90. PMID: 13973786

Hydrochlorothiazide Identification

Substance Name

Hydrochlorothiazide

CAS Registry Number

58-93-5

Drug Class

Antihypertensive Agents

Thiazide Diuretics

Administrative Information

LactMed Record Number

137

Last Revision Date

20130907

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