Transfer of doxazosin into breast milk

J Hum Lact. 2013 May;29(2):150-3. doi: 10.1177/0890334412473203. Epub 2013 Feb 25.

Abstract

To the best of our knowledge, there have been no published studies of doxazosin transfer into human milk. In rats, milk concentrations twentyfold higher than in plasma have been reported. Based on these animal data, some references advise to avoid breastfeeding during doxazosin therapy. However, the physicochemical properties of doxazosin suggest low transfer into human milk. A 37-year-old breastfeeding woman who was administered doxazosin 4 mg daily for 2 doses was studied. Doxazosin concentrations in milk and plasma were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The milk/plasma area under the concentration-time curve (AUC0-18 hours) ratio was 0.1. This finding is consistent with what could be predicted based on the physicochemical properties of doxazosin. The average and maximum milk concentrations were 2.9 and 4.2 µg/L. These values correspond to estimated relative infant doses of 0.06% and 0.09%, respectively, assuming standard infant milk intake. These values are well below the generally accepted cutoff of 10% for predicting safety during breastfeeding. A low relative infant dose of < 0.1% suggests that maternal doxazosin therapy may be compatible with breastfeeding after careful individual risk-benefit analysis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antihypertensive Agents / analysis
  • Antihypertensive Agents / pharmacokinetics*
  • Area Under Curve
  • Chromatography, Liquid
  • Doxazosin / analysis
  • Doxazosin / pharmacokinetics*
  • Female
  • Humans
  • Milk, Human / chemistry*
  • Tandem Mass Spectrometry
  • Time Factors

Substances

  • Antihypertensive Agents
  • Doxazosin