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Pharmacy and Medications

Medication During Lactating

08/11/2010

Question:

My wife, who is 27 and mother of a 9 month old baby girl, has high blood pressure that developed during her pregnancy. Post delivery her blood pressure is 140/90 without medication.  Her doctor advised her to take Olmestran Medoxomil 20mg & Hydrochlorothiazide tablets regularly. She has taken these medications for the last 3 months while breast feeding our child. Is it advisable to consume these medicines while breast feeding.

Answer:

All medications taken during pregnancy or while breast-feeding should be reviewed with your doctor to ensure they are needed. It is important to make sure your doctor knows that your wife is breast-feeding because any medication can be a potential risk to the baby. Olmesartan is a relatively new medicine and there is no information on human use while breast-feeding. Because of this, a potential risk to the baby cannot be ruled out. Hydrochlorothiazide at doses of 50mg or less is usually alright to take while breast feeding.

Depending on how high your wife’s blood pressure is without any medications, she may not need to take any medications while breast feeding. If her blood pressure is 140/90 or less without medications she may not to treat her high blood pressure during the time she will be breast feeding your daughter.

If your wife’s blood pressure is 140/90 or more while taking her blood pressure medicines she may need to continue treating her high blood pressure. If a blood pressure medicine is needed, your doctor may want to consider a medicine other than Olmesartan. Perhaps one has been studied in women who are breast-feeding. One option might be taking the hydrochlorothiazide alone. Other options are Methyldopa or Nifedipine.

Your doctor is the best person to help you decide what is most appropriate for your wife in this situation. A pharmacist who knows you may provide additional information to help resolve these issues.

This response was prepared in part by Madeline Stephens and David Jager,
PharmD Candidates 2011 at the University of Cincinnati College ofPharmacy.

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Response by:

Robert James Goetz, PharmD, DABAT
Assistant Professor of Pharmacy Practice
College of Medicine
University of Cincinnati