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Ester and prodrug of epinephrine (FDA 2000, Goldberg 1980) which is used as topical eye drops for treatment of glaucoma.
Administration: 1 drop in affected eye every 12 hours.
At the time this last update was completed, we did not find published data regarding the excretion of this substance through breast milk.
Its low oral bioavailability hinders its passage to the infant's plasma from ingested milk.
A newborn whose mother was treated with dipivefrine had no clinical problems (Johnson 2001).
Because the small dose used and poor plasma absorption of most ophthalmic preparations it is unlikely the passage of significant amount into breast milk.
Epinephrine is destroyed in the gastrointestinal tract. The low oral-bioavailability makes its levels into infant's plasma, that would be absorbed from ingested breast milk, be nil or negligible.
Absorption should be minimized by closing the eye after instillation, applying pressure for 1 to 5 minutes with your finger on the tear duct at the inner corner of the eye and administering the dose immediately after nursing (Belkin 2020, Johnson 2001).
Expert authors consider the use of this medication to be safe or very probably safe during breastfeeding (Hale 2021).