Is Treprostinil safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Treprostinil. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A woman developed pulmonary artery hypertension and was treated with intravenous treprostinil beginning at 32 weeks of gestation and titrated up to 26 ng/kg/min. The dose was nearly doubled postpartum because of worsening symptoms. She breastfed (extent not stated) her infant for one year with no apparent drug-related problems, although there was concern for obesity at 6 months of age. The infant was healthy and developing normally at 2 years of age.[ 2 ] A woman with pulmonary arterial hypertension initially received treprostinil by continuous infusion and then by subcutaneous injection in a dose of 30 ng/kg per minute (2,352 ng/min). She partially (extent not stated) breastfed her infant and at 7 weeks postpartum, no adverse effects were reported in her infant.[ 1 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. A woman with pulmonary arterial hypertension received treprostinil by continuous infusion in a dose of 30 ng/kg per minute (2,352 ng/min), for 10 days postpartum. A milk sample taken at that time contained no detectable treprostinil ( 0.05 mcg/L). The milk sample was frozen at -80 degrees C, which was subsequently found to reduce the concentration of treprostinil in milk by 16 to 18%. The average maternal serum concentration at that time was 2.2 mcg/L and unaffected by freezing. Treprostinil was changed to the subcutaneous route at the same dose and at 7 weeks postpartum, the average treprostinil concentration in milk that was immediately assayed and not frozen was 1.02 mcg/L and serum the average serum level was 5.65 mcg/L.[ 1 ] Using the standard milk ingestion of 150 mL/kg daily, the relative infant dose would be 0.35%. Additionally, the oral bioavailability of treprostinil is only about 17%, for an effective RID of 0.06%. 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.