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Review
. 2025 May 8:55:100552.
doi: 10.1016/j.ahjo.2025.100552. eCollection 2025 Jul.

Lactation safety of cardiovascular medications

Cristina Nunez-Pellot  1 , Allison Akers  2 , Sarah Običan  2 , Mary Ashley Cain  2 , Daniela R Crousillat  1   2   3
Affiliations
Review

Lactation safety of cardiovascular medications

Cristina Nunez-Pellot et al. Am Heart J Plus. .

Abstract

Breastfeeding is the gold standard for infant feeding with well-established maternal, neonatal, and pediatric benefits. Patients with preexisting cardiovascular disease have lower breastfeeding rates than the general population. While little evidence exists regarding specific barriers to lactation in patients with preexisting cardiovascular disease, concerns regarding lactation safety and medication exposure in mothers with cardiovascular disease may be a cause for early breastfeeding cessation despite known health benefits. This literature review highlights the lactation safety of common cardiac medications. While some common cardiac medications may have limited safety data available, general pharmacokinetic principles of drug secretion in lactation can help to guide shared decision making in discussion with the patient. Enhancing provider knowledge regarding cardiac medication safety during breastfeeding may improve lactation outcomes in this population.

Keywords: Breastfeeding; Cardiovascular diseases; Lactation; Medication safety; Peripartum cardiomyopathy; Postpartum.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for this journal and was not involved in the editorial review or the decision to publish this article.

Figures

Figure 1
Figure 1
Pharmacokinetics of medications in lactation.
See this image and copyright information in PMC

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