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Phenoxybenzamine is a potent, long-acting blocker of alpha-adrenergic receptors in smooth muscle that produces a block with peripheral vasodilation that can last for 3 days or more. It is used in the treatment of hypertension and hyperhidrosis associated with pheochromocytoma, severe shock, and urinary retention. It is administered orally or intravenously in two daily doses.
At the time of the last update, we found no published data on its excretion in breast milk.
Drug with very limited known pharmacokinetic data, which does not allow for predicting the amount of its possible excretion in breast milk.
Its half-life (T ½) of 24 hours is incompatible with waiting, after administration of the dose, several T ½ to breastfeed in order to minimise possible transfer to breast milk.
The only factor in favour of compatibility with breastfeeding is its very low oral bioavailability (less than 30%), which hinders its passage into the infant's plasma from ingested breast milk, except in premature babies and during the immediate neonatal period, when there may be greater intestinal permeability.
Side effects (hypotension, tachycardia) can be serious. If administered during breastfeeding, the infant should be clinically monitored.
Until there is further published data on this drug in relation to breastfeeding, known safer alternatives (García 2021) may be preferable, especially during the neonatal period and in the event of prematurity.