The Basics
What is Propranolol?
Can treat high blood pressure, chest pain, and uneven heartbeat. Can also treat tremors and proliferating infantile hemangioma and prevent migraine headaches.
Brand names for Propranolol
Inderal
How Propranolol is classified
Antihypertensive Agents, Adrenergic Beta-Antagonists, Antiarrhythmics, Antiarrhythmics
Propranolol During Pregnancy
Propranolol pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Propranolol while pregnant
N/A
Taking Propranolol While Breastfeeding
What are recommendations for lactation if you're taking Propranolol?
Because of the low levels of propranolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. Studies during breastfeeding have found no adverse reactions in breastfed infants clearly attributable to propranolol. No special precautions are required. Propranolol has been used successfully in cases of persistent pain of the breast during breastfeeding.[1]
Maternal / infant drug levels
Because of the low levels of propranolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. Studies during breastfeeding have found no adverse reactions in breastfed infants clearly attributable to propranolol. No special precautions are required. Propranolol has been used successfully in cases of persistent pain of the breast during breastfeeding.[1]
Possible effects of Propranolol on milk supply
Relevant published information on the effects of beta-blockade or propranolol during normal lactation was not found as of the revision date. A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol.[14]
Possible alternatives to Propranolol
Labetalol, Metoprolol.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Muddana A, Asbill DT, Jerath MR et al. Quantitative sensory testing, antihistamines, and beta-blockers for management of persistent breast pain: A case series. Breastfeed Med. 2018;13:275-80. PMID: 29630399
2. Riant P, Urien S, Albengres E et al. High plasma protein binding as a parameter in the selection of betablockers for lactating women. Biochem Pharmacol. 1986;35:4579-81. PMID: 2878668
3. Lewis AM, Patel L, Johnston A et al. Mexiletine in human blood and breast milk. Postgrad Med J. 1981;57:546-7. PMID: 7329891
4. Anderson PO, Salter FJ. Propranolol therapy during pregnancy and lactation. Am J Cardiol. 1976;37:325. Letter. PMID: 1246962
5. Levitan AA, Manion JC. Propranolol therapy during pregnancy and lactation. Am J Cardiol. 1973;32:247. Letter. PMID: 4721124
6. Thorley KJ, McAinsh J. Levels of the beta-blockers atenolol and propranolol in the breast milk of women treated for hypertension in pregnancy. Biopharm Drug Dispos. 1983;4:299-301. PMID: 6626704
7. Karlberg B, Lundberg D, Aberg H. Excretion of propranolol in human breast milk. Acta Pharmacol Toxicol. 1974;34:222-4. PMID: 4406326
8. Smith MT, Livingstone I, Hooper WD et al. Propranolol, propranolol glucuronide, and naphthoxylactic acid in breast milk and plasma. Ther Drug Monit. 1983;5:87-93. PMID: 6845404
9. Bauer JH, Pape B, Zajicek J et al. Propranolol in human plasma and breast milk. Am J Cardiol. 1979;43:860-2. PMID: 425926
10. Taylor EA, Turner P. Anti-hypertensive therapy with propranolol during pregnancy and lactation. Postgrad Med J. 1981;57(669):427-30. PMID: 7312737
11. Atkinson HC, Begg EJ, Darlow BA. Drugs in human milk. Clinical pharmacokinetic considerations. Clin Pharmacokinet. 1988;14:217-40. PMID: 3292101
12. Ho TK, Moretti ME, Schaeffer JK et al. Maternal beta-blocker usage and breast feeding in the neonate. Pediatr Res. 1999;45:67A. Abstract 385.
13. Soussan C, Gouraud A, Portolan G et al. Drug-induced adverse reactions via breastfeeding: A descriptive study in the French Pharmacovigilance Database. Eur J Clin Pharmacol. 2014;70:1361-6. PMID: 25183382
14. Board JA, Fierro RJ, Wasserman AJ. Effects of alpha- and beta-adrenergic blocking agents on serum prolactin levels in women with hyperprolactinemia and galactorrhea. Am J Obstet Gynecol. 1977;127:285-7. PMID: 556882
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
