Is Sacubitril 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 Sacubitril. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Sacubitril is available in the United States only in combination with valsartan. Milk levels after the lowest dose of the combination are very low. If sacubitril milk levels of the highest dosage (4 times greater) are proportional to maternal dosage, they would still be quite low. Valsartan was undetectable at this dosage, so the combination product appears unlikely to affect the nursing infant.
Effects on the breastfed infant
Two women taking sacubitril 24 mg and valsartan 26 mg (Entresto) did not observe any symptoms in their breastfed infants. Their extent of breastfeeding was not reported.[1]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Five mothers taking sacubitril 24 mg and valsartan 26 mg (Entresto) twice daily collected milk samples at 0, 1, 2, 4, 6, 8, 10, and 12 hours after taking a dose at steady state. The peak sacubitril milk concentration of 12.2 mcg/L occurred at 1 hour after the dose. Its average concentration was 0.497 mcg/L. The peak LBQ657 milk concentration of 1.52 mcg/L occurred at 4 hours after the dose. Its average concentration was 9.5 mcg/L. Calculated infant dosages of sacubitril and its metabolite were 0.98 mcg/kg and 1.42 mcg/kg daily, which translate into 0.01% and 0.22%, respectively.[1]
Infant Levels. Relevant published information was not found as of the revision date.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Sacubitril” (LM1289). 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.