Carvedilol

Drug Levels and Effects:




Summary of Use during Lactation:


Based on its physicochemical properties, carvedilol appears to present a low-risk to the breastfed infant. Because there is no published experience with carvedilol during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.


Drug Levels:


The excretion ofbeta-adrenergic blocking drugs into breastmilk is largely determined by their protein binding. Those with low binding are more extensively excreted into breastmilk.[1] Accumulation of the drugs in the infant is related to the fraction excreted in urine. With 95% protein binding, 1% renal excretion and a moderately long half-life, carvedilol presents a low risk for accumulation in infants.

Maternal Levels.

Relevant published information was not found as of the revision date.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


A study of mothers takingbeta-blockers during nursing found a numerically, but not statistically significant increased number of adverse reactions in those taking anybeta-blocker. Although the ages of infants were matched to control infants, the ages of the affected infants were not stated. None of the mothers were taking carvedilol.[2]


Possible Effects on Lactation:


Relevant published information on the effects ofbeta-blockade or carvedilol during normal lactation was not found as of the revision date. A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels followingbeta-adrenergic blockade with propranolol.[3]


Alternate Drugs to Consider:


Propranolol,Labetalol,Metoprolol


References:


1. Riant P, Urien S, Albengres E et al. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986;35:4579-81. PMID:2878668
2. Ho TK, Moretti ME, Schaeffer JK et al. Maternalbeta-blocker usage and breast feeding in the neonate. Pediatr Res. 1999;45:67A. Abstract 385.
3. Board JA, Fierro RJ, Wasserman AJ et al. Effects of alpha- andbeta-adrenergic blocking agents on serum prolactin levels in women with hyperprolactinemia and galactorrhea. Am J Obstet Gynecol. 1977;127:285-7. PMID:556882



Substance Identification:




Substance Name:

Carvedilol

CAS Registry Number:

72956-09-3

Drug Class:


  • Antihypertensive Agents

  • Adrenergic
  • Beta
  • -Antagonists

  • Antirrhythmics


  • Administrative Information:




    LactMed Record Number:


    286


    Last Revision Date:


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