Is Atorvastatin safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Atorvastatin. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
In a case series of patients with homozygous familial hypercholesterolemia, 6 patients breastfed 11 infants after restarting statin therapy postpartum. The specific statin used by these women was not reported, most of the women on statin therapy were using atorvastatin, either 40 or 80 mg, daily. Normal early child development was reported for all offspring. Children started school at the appropriate age and no learning difficulties were reported.[ 3 ] Two women who were taking atorvastatin in doses of 20 and 40 mg daily partially breastfed their infants. Mothers reported no infant adverse effects and no concerns about their development.[ 2 ]
Effects on milk supply
Gynecomastia has been reported in men taking atorvastatin.[ 4 - 6 ] Serum prolactin was normal in one case where it was measured.[ 6 ] In another case, possible rosuvastatin-induced gynecomastia resolved after the patient s medication was changed to atorvastatin.[ 7 ] Three women who were taking atorvastatin in doses of 20, 40 and 80 mg once daily donated milk samples at 0, 1, 2, 4, 6, 8, 10, 12, and 24 hours after their dose. Aliquots of complete milk collections were analyzed for cholesterol. Milk cholesterol levels were within previously established norms in the range of 10 mg/dL.[ 2 ]
Levels in milk
Maternal Levels. Three women who were taking atorvastatin in doses of 20, 40 and 80 mg once daily donated milk samples at 0, 1, 2, 4, 6, 8, 10, 12, and 24 hours after their dose. Aliquots of complete milk collections from both breasts were analyzed for atorvastatin and its active metabolites. The absolute infant dosages of atorvastatin was calculated at 0.066, 0.19, and 0.27 mcg/kg daily for the 20 mg, 40 mg, and 80 mg doses, respectively. The weight-adjusted relative infant dose of atorvastatin, 2-hydroxy- and 4-hydroxyatorvastatin was 0.05%, 0.09%, and 0.052% for atorvastatin doses of 20 mg, 40 mg, and 80 mg, respectively.[ 2 ] Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.