Is Drospirenone safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Drospirenone. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Drospirenone is a progestin that is an analogue of spironolactone. It has antimineralocorticoid and antiandrogenic activities. Amounts in milk are very low and no adverse effects on the breasted infant or milk supply are expected. Expert opinion holds that the risks of progestin-only contraceptive products usually are acceptable for nursing mothers at any time postpartum.[1,2] For further information, consult the record entitled, Contraceptives, Oral, Combined.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Six women who were between 1 week and 3 months postpartum received a single dose of drospirenone 3 mg plus ethinyl estradiol 30 mcg. Milk was collected for 72 hours after the dose in 2 of the women in whom half-lives in breastmilk were 8.3 and 15.5 hours. The average peak milk level in the 6 women was 13.5 mcg/L at 2.8 hours after the dose. The average drospirenone milk level in the first 24 hours was 3.7 mcg/L (range 1.4 to 7 mcg/L). The authors estimated that a fully breastfed infant would receive a drospirenone dose of about 3 mcg daily.[3] Using the average milk level of drospirenone, an exclusively breastfed infant would receive 1.1% of the weight-adjusted maternal dosage of drospirenone.
Twelve women who had weaned their infants, but were still lactating were given non-micronized oral drospirenone 4 mg daily (Slinda-Exeltis, Germany). Blood and milk samples were obtained at 12 time points up to 120 hours after at least 7 days of use. The average peak concentration in milk was 10.3 mcg/L at 3 hours after the dose and the average milk concentration over 24 hours would be 5.6 mcg/L. Using the standard milk intake value of 150 mL/kg daily, the infant would receive an average of 0.84 mcg/kg of drospirenone daily, which represent a weight-adjusted relative infant dose of 1.25% of the maternal dose.[4]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Drospirenone is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Drospirenone” (LM480). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.