Safety in Lactation: Drugs for obstructive airways disease

Additional information relating to breastfeeding

To be used in conjunction with individual drug entries for specific information and guidance.

Bronchodilators

Most bronchodilators are considered to be safe with breastfeeding, although published evidence is small. In general, inhaled preparations are preferred as maternal levels will be lower than after oral or parenteral administration.

Some of the inhaled antimuscarinic and beta2 agonist bronchodilators are in combination products, either with other bronchodilators or corticosteroids. Assessment of use in breastfeeding should be based on the risk of individual components. In practice, combination inhaled products present no additional risk over the individual drugs.

Inhaled corticosteroids

The amounts of inhaled corticosteroids absorbed into the maternal bloodstream and excreted into breast milk are considered to probably be too small to affect a breastfed infant.

Some of the inhaled corticosteroids are in combination products with bronchodilators. Assessment of use in breastfeeding should be based on the risk of individual components. In practice, combination inhaled products present no additional risk over the individual drugs.

Other drugs for obstructive airways disease
(includes ephedrine, mepolizumab, montelukast, nedocromil, omalizumab, reslizumab, roflumilast, sodium cromoglicate, zafirlukast)

The drugs in this section have a variety of indications associated with asthma and related conditions. Where appropriate, the choice of an alternative will depend on the indication.