Is Furosemide safe while breastfeeding?

Effects on the breastfed infant

Anecdotal, short-term observations at one medical center found no adverse infant effects from maternal use of furosemide in the immediate postpartum period.[ 1 ]

Effects on milk supply

Furosemide 20 mg intramuscularly on the first postpartum day followed by 40 mg orally for 4 days has been used in conjunction with fluid restriction and breast binding to suppress lactation within 3 days postpartum.[ 2 ] The added contribution of furosemide to fluid restriction and breast binding, which are effective in suppressing lactation, is not known. No data exist on the effects of loop diuretics on established lactation. A randomized, controlled trial compared postpartum furosemide (n = 192) to placebo (n = 192) in women who had gestational hypertension and preeclampsia. Patients received either a 4- to 5-day course of 20 mg oral furosemide daily or placebo. The first dose was given 6 to 24 hours postpartum and then every 24 hours thereafter until hospital discharge. No difference was found in patient-reported breastfeeding difficulties between the two groups.[ 3 ] A study of mothers with antepartum hypertension were given either furosemide 20 mg or a placebo daily for 5 days postpartum. Mothers reported whether they were exclusively breastfeeding at 2 and 6 weeks postpartum. No difference was found in the rates of exclusive breastfeeding between the furosemide and placebo groups.[ 4 ]

Levels in milk

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.

Alternatives LactMed lists

• Chlorothiazide
• Hydrochlorothiazide