Is Eplerenone 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 Eplerenone. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Data from one mother-infant pair indicate that eplerenone is poorly excreted into breastmilk. Until more data are available, eplerenone should be used with careful infant monitoring during breastfeeding.
Effects on the breastfed infant
A woman with primary aldosteronism was receiving eplerenone 50 mg once daily (0.79 mg/kg daily) during pregnancy and postpartum. Her infant was partially breastfed for 3 months, with over 50% of nutrition from breastmilk. The infant developed normally and had no detectable adverse drug effects at the 1- or 3-month checkups.[1]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. A woman with primary aldosteronism was receiving eplerenone 50 mg (0.79 mg/kg) once daily during pregnancy and postpartum. On postpartum day 7, eplerenone breastmilk concentrations were measured at 1, 1.5, and 11.5 hours after the dose. Eplerenone milk concentrations were 0, 104.1, and 61.3 mcg/L, respectively. On postpartum day 35, eplerenone milk concentrations were measured at 1, 4, 6.5, 13.5, 18.5, and 22 hours after the dose. Eplerenone milk concentrations were 130.2, 161.2, 55.8, 6.0, 0.7, and 0.3 mcg/L, respectively. The authors calculated a maximum daily infant dose of eplerenone, based on the maximum detected eplerenone concentration in breastmilk, to be 0.024 mg/kg daily, which corresponds to a weight-adjusted dosage of 3% relative to the maternal dosage.[1] The average daily and relative dosages would be considerably less.
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Eplerenone in pregnancy
LactMed covers breastfeeding only. For what the NHS and the US prescribing label say about pregnancy, see:
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Eplerenone” (eplerenone). 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.