Is Methyldopa safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Methyldopa. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
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 oral methyldopa 0.25 to 1.5 grams daily.[ 1 - 4 ]
Effects on milk supply
Methyldopa can increase serum prolactin and has caused galactorrhea.[ 5 - 8 ] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Levels in milk
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 gram daily.[ 1 ] 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.[ 2 ] Infant Levels. No methyldopa was detectable ( 200 mcg/L) in the serum of an infant whose mother was taking methyldopa 250 mg twice daily. The infant's urine contained a methyldopa concentration of 3.8 mg/L.[ 3 ] In an 8-week-old infant whose mother was receiving 1 gram daily of methyldopa, a serum level of 90 mcg/L was found 10 hours after a 500 mg maternal dose. Another 1-week-old infant whose mother was receiving 500 mg daily had no detectable drug in the serum ( 50 mcg/L).[ 2 ]
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.