Last update April 15, 2024

Acebutolol

Limited compatibility

Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

Acebutolol is a cardio-selective beta-blocker, used in the treatment of hypertension, angina pectoris and cardiac arrhythmias. It is administered orally once or twice daily and by slow intravenous injection for emergency treatment of arrhythmias. Acebutolol is used in neonates and young infants (treatment of subglottic and infantile hemangiomas) at doses of 8 mg/kg/day. (Frieden 2011, Blanchet 2010)

Acebutolol and its active metabolite, diacetolol, are excreted in breast milk in small, possibly non-significant concentration. (FDA 2007, Abolfazl 2003, Atkinson 1988, Boutroy 1986, Bianchetti 1981)

Symptoms of β-blockade (hypotension, bradycardia, and transient tachypnea) were observed in one infant, although he was already exposed to acebutolol in utero (Boutroy 1986) and infants exposed to acebutolol intrauterinally may show alterations in heart rhythm at birth, blood pressure and blood glucose levels, regardless of their exposure to acebutolol through breast milk (Boutroy 1986 and 1982, Dumez 1981), and treatment should be discontinued 8 to 12 hours before birth (Morselli 1989). Two other newborns and one infant had no clinical problems. (Ho 1999, Boutroy 1986)

The pharmacokinetic characteristics of acebutolol, such as low percentage binding to plasma proteins (FDA 2007, Riant 1986, Bianchetti 1981), low lipid solubility, longer half-life of the active metabolite diacetolol (FDA 2007) and mainly renal excretion (Schaefer 2007 p 689) make acebutolol less favorable for nursing mothers, compared to other beta-blockers, especially in mothers who are breastfeeding a newborn or premature infant, so safer known alternatives may be preferable, especially during the neonatal period and in case of prematurity. (Kearney 2018, Anderson 2018, Rowe 2013, Ghanem 2008, Schaefer 2007, Chow 1998, Riant 1986)

The American Academy of Pediatrics considers that acebutolol should be administered with caution to breastfeeding mothers (AAP 2001). Some authors do not consider beta blockers to be the drugs of choice for the treatment of hypertension unless there is another concurrent indication, such as migraine or prophylaxis with angina pectoris. (Anderson 2018) 

The protective role of breastfeeding against maternal hypertension has been demonstrated. (Park 2018)


See below the information of this related product:

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Acebutolol is also known as


Acebutolol in other languages or writings:

Tradenames

Main tradenames from several countries containing Acebutolol in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 35 - 50 %
Molecular weight 336 daltons
Protein Binding 26 %
VD 1.2 l/Kg
pKa 13.9 -
Tmax 2 - 4 hours
3 - 4 (metab: 8 - 13) hours
M/P ratio 7 (metab: 12 - 25) -
Theoretical Dose 0.043 - 0.62 mg/Kg/d
Relative Dose 1.3 - 3.1 %
Ped.Relat.Dose 0.5 - 7.7 %

References

  1. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018 Abstract
  2. Kearney L, Wright P, Fhadil S, Thomas M. Postpartum Cardiomyopathy and Considerations for Breastfeeding. Card Fail Rev. 2018 Abstract Full text (link to original source) Full text (in our servers)
  3. Park S, Choi NK. Breastfeeding and Maternal Hypertension. Am J Hypertens. 2018 Abstract
  4. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  5. Frieden IJ. Infantile hemangioma research: looking backward and forward. J Invest Dermatol. 2011 Abstract
  6. Blanchet C, Nicollas R, Bigorre M, Amedro P, Mondain M. Management of infantile subglottic hemangioma: acebutolol or propranolol? Int J Pediatr Otorhinolaryngol. 2010 Abstract
  7. Ghanem FA, Movahed A. Use of antihypertensive drugs during pregnancy and lactation. Cardiovasc Ther. 2008 Abstract Full text (link to original source) Full text (in our servers)
  8. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  9. FDA-Reddy. Acebutolol. Drug Summary. 2007 Full text (in our servers)
  10. Abolfazl Mostafavi S, Stinson DA, Dooly K, Jamali F. Excretion of acebutolol and its major metabolite diacetolol into infant blood circulation and the breast milk. Iran J Pharm Res. 2003;2:141–4. Full text (link to original source) Full text (in our servers)
  11. Ho T, Moretti M, Shaeffer I, Ito S, Koren G. Maternal β-Blocker Usage and Breast Feeding in the Neonate. Pediatr Res. 1999;45:67. Poster 385. Full text (link to original source) Full text (in our servers)
  12. Chow T, Galvin J, McGovern B. Antiarrhythmic drug therapy in pregnancy and lactation. Am J Cardiol. 1998 Abstract
  13. Morselli PL, Boutroy MJ, Bianchetti G, Thénot JP. Pharmacokinetics of antihypertensive drugs in the neonatal period. Dev Pharmacol Ther. 1989 Abstract
  14. Atkinson HC, Begg EJ, Darlow BA. Drugs in human milk. Clinical pharmacokinetic considerations. Clin Pharmacokinet. 1988 Abstract
  15. Boutroy MJ, Bianchetti G, Dubruc C, Vert P, Morselli PL. To nurse when receiving acebutolol: is it dangerous for the neonate? Eur J Clin Pharmacol. 1986 Abstract
  16. Riant P, Urien S, Albengres E, Duche JC, Tillement JP. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986 Abstract
  17. Boutroy MJ, Vert P, Bianchetti G, Dubrucq C, Morselli PL. Infants born to hypertensive mothers treated by acebutolol. Pharmacological studies in the perinatal period. Dev Pharmacol Ther. 1982 Abstract
  18. Bianchetti G, Boutroy MJ, Dubruc C, Morselli PL, Vert P. Placental transfer and pharmacokinetics of acebutolol and N-acetyl acebutolol in the newborn. Proceedings of the Joint meeting of the Italian and British Pharmacological Societies. Verona 30.07.1980.Br J Pharmacol. 1981;72:135. Br J Pharmacol. 1981
  19. Bianchetti G, Dubruc C, Vert P, Boutroy, J, Morselli PL., Placental transfer and pharmacokinetics of acebutolol in newborn infants. Clin Pharmacol Ther. 1981;29:233. Clin Pharmacol Ther. 1981
  20. Dumez Y, Tchobroutsky C, Hornych H, Amiel-Tison C. Neonatal effects of maternal administration of acebutolol. Br Med J (Clin Res Ed). 1981 Abstract

Total visits

6,159

Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write us at elactancia.org@gmail.com

e-lactancia is a resource recommended by El Parto Es Nuestro of Spain

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM