Hydrochlorothiazide use while Breastfeeding
Drugs containing Hydrochlorothiazide: Hyzaar, Dyazide, Maxzide, Ziac, Zestoretic, Tribenzor, Benicar HCT, Avalide, Diovan HCT, HydroDIURIL, Show all 78 »Microzide, Prinzide, Aldactazide, Accuretic, Exforge HCT, Moduretic, Esidrix, Vaseretic, Micardis HCT, Atacand HCT, Lopressor HCT, Maxzide-25, Lotensin HCT, Dutoprol, Quinaretic, Amturnide, Oretic, HydrALAZINE Plus, Inderide, Aquazide H, Diuretic Ap-Es, Carozide, Ezide, Apresazide, Moduretic 5-50, Uniretic, Tekturna HCT, Aldoril, Aldoril D50, Diaqua, Monopril HCT, Esimil, Hydra-Zide, Hydroserpine, Hydropres-50, Hydro-Reserp, Hydroserpine 1, Hydropres-25, Teveten HCT, Vaseretic 5-12.5, Hydroserp, Vaseretic 10-25, Oreticyl 25, Capozide, Capozide 50/25, Oreticyl 50, Timolide 10-25, Oreticyl Forte, Timolide, Inderide LA, HHR, Serathide, Hydrap-ES, Marpres, Capozide 25/15, Loqua, Capozide 50/15, Hydro Par, Tri-Hydroserpine, Uni Serp, Ser-Ap-Es, Capozide 25/25, Serpex, Serpazide, Aldoril D30, Aldoril 15, Aldoril 25, Unipres
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.
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.
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.
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.
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. Intense diuresis with thiazides and thiazide-like diuretics, fluid restriction and breast binding have been used to suppress postpartum lactation. 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
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
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