Methyldopa use while Breastfeeding
Drugs containing Methyldopa: Aldomet, Aldoril, Aldoclor-250, Aldoril D50, Aldoril 15, Aldoclor-150, Aldoril D30, Aldoril 25
Methyldopa Levels and Effects while Breastfeeding
Summary of Use during Lactation
Because of the low levels of methyldopa in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. No special precautions are required.
Maternal Levels. Three women who were 2 to 15 days postpartum were taking 250 mg of methyldopa orally 3 or 4 times daily. Randomly drawn milk samples had levels of drug and conjugate that ranged from < 0.1 to 0.5 mg/L at a dose of 750 mg daily and were 0.8 mg/L at a dose of 1 g daily.
In 3 women who were 1 to 8 weeks postpartum, peak levels of drug and conjugate occurred between 3 and 6 hours after the dose. Peak levels of drug and conjugate after a dose of 500 mg were 0.2, 0.66 and 1.14 mg/L in 3 mothers' milk. The authors estimated an infant dosage of less than 0.2% of the mother's total dosage.
Infant Levels. No methyldopa was detectable (<200 mcg/L) in the serum on an infant whose mother was taking methyldopa 250 mg twice daily. The infant's urine contained a methyldopa concentration of 3.8 mg/L.
In an 8-week-old infant whose mother was receiving 1 g daily of methyldopa, a serum level of 90 mcg/L was found 10 hours after a 500 mg maternal dose; a 1-week-old infant whose mother was receiving 500 mg daily had no detectable drug in the serum (<50 mcg/L).
Effects in Breastfed Infants
No acute or long-term adverse effects were reported in any 15 infants ranging in age from less than 1 week to 8 weeks of age whose mothers were taking methyldopa 0.25 to 1.5 g/day orally.
Effects on Lactation and Breastmilk
Methyldopa can increase serum prolactin and has caused galactorrhea. The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Alternate Drugs to Consider
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