Last update April 16, 2024

Furosemide

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Diuretic drug with action on the Henle's loop of the nephron. Indicated in the treatment of edema secondary to heart failure, hepatic or renal disease and in the treatment of hypertension. Oral or parenteral administration once or twice a day.

Although the manufacturer says that it is excreted in the mother's milk (Cinfa 2018, Sanofi 2018), at latest update, relevant published data on excretion into breast milk were not found.

Its high protein-binding capacity and short acting (short half-life) make excretion into breast milk in significant amount unlikely. (Kearney 2018)

Because of a low oral bioavailability, mostly in the neonatal period (Kearney 2018), absorption from the ingested milk is thought to be minimal.

No problems have been observed in infants whose mothers have taken Furosemide (Anderson 2018 & 2016, Soussan 2014, Anderson 2003, Ito 1993). No breastfeeding problems have been observed in mothers treated with furosemide in the first few days immediately postpartum. (Lopes 2021)

Authorized use in the neonatal period.

Anecdotally and poorly proven, furosemide was used along with water restriction for inhibition of lactation (Cominos 1976). Furosemide does not reduce prolactin levels (Kalk 1977). Despite some older studies, there is no scientific evidence that diuretics reduce breast milk production. (Rowe 2013)

In 2018, a mother reported decreased milk production after the seventh day of treatment (Annotated in "Help us improve this entry").

Several medical societies, experts and expert consensus, consider the use of this medication safe or probably safe during breastfeeding. (Briggs 2015, Hale 2017 p 409, Kearney 2018, Malachias 2016, Schaefer 2007 p691)

Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable.

Long-term treatment with diuretic drugs, particularly Thiazides with long-lasting effect and action on the Henle's loop, may compromise the state of hydration of the nursing mother. Must make an adjustment (decrease) of the dose based on the estimated milk production and monitor milk production.

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

Furosemide in other languages or writings:

Group

Furosemide belongs to this group or family:

Tradenames

Main tradenames from several countries containing Furosemide in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 44 - 71 %
Molecular weight 331 daltons
Protein Binding 99 %
VD 0.1 - 0.2 l/Kg
pKa 4.25 -
Tmax 1 - 2 hours
0.5 - 1.5 hours

References

  1. Lopes Perdigao J, Lewey J, Hirshberg A, Koelper N, Srinivas SK, Elovitz MA, Levine LD. Furosemide for Accelerated Recovery of Blood Pressure Postpartum in women with a hypertensive disorder of pregnancy: A Randomized Controlled Trial. Hypertension. 2021 May 5;77(5):1517-1524. Abstract Full text (link to original source)
  2. AEMPS-Cinfa. Furosemida. Ficha técnica. 2018 Full text (in our servers)
  3. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018 Abstract
  4. 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)
  5. Sanofi. Furosemide. Drug Summary. 2018 Full text (in our servers)
  6. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  7. Malachias MV, Figueiredo CE, Sass N, Antonello IC, Torloni MR, Bortolotto MRF L. 7th Brazilian Guideline of Arterial Hypertension: Chapter 9 - Arterial Hypertension in pregnancy Arq Bras Cardiol. 2016 Abstract Full text (link to original source)
  8. Anderson PO, Manoguerra AS, Valdés V. A Review of Adverse Reactions in Infants From Medications in Breastmilk. Clin Pediatr (Phila). 2016 Abstract
  9. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  10. Soussan C, Gouraud A, Portolan G, Jean-Pastor MJ, Pecriaux C, Montastruc JL, Damase-Michel C, Lacroix I. Drug-induced adverse reactions via breastfeeding: a descriptive study in the French Pharmacovigilance Database. Eur J Clin Pharmacol. 2014 Abstract
  11. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  12. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  13. Anderson PO, Pochop SL, Manoguerra AS. Adverse drug reactions in breastfed infants: less than imagined. Clin Pediatr (Phila). 2003 Abstract
  14. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract
  15. Smith DE, Lin ET, Benet LZ. Absorption and disposition of furosemide in healthy volunteers, measured with a metabolite-specific assay. Drug Metab Dispos. 1980 Abstract
  16. Kalk WJ, Cominos DC, van der Walt A, van Rooyen AJ. The effect of furosemide on serum prolactin levels in the postpartum period. S Afr Med J. 1977 Abstract
  17. Cominos DC, van der Walt A, van Rooyen AJ. Suppression of postpartum lactation with furosemide. S Afr Med J. 1976 Abstract

Total visits

157,271

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 Academy of Breastfeeding Medicine - 2015 of United States of America

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