Can you take alendronate while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Limited evidence indicates that breastfeeding after cessation of long-term bisphosphonate treatment appears to have no adverse effects on the infant. Because no information is available on the use of alendronate during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. However, absorption of alendronate by a breastfed infant is unlikely. If the mother receives a bisphosphonate during pregnancy or nursing, some experts recommend monitoring the infant's serum calcium during the first 2 months postpartum.
Quoted from Alendronate — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised December 3, 2018.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of alendronate. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Pamidronate
How much alendronate gets into breastmilk
Alendronate is poorly absorbed orally (average in adults 1% on an empty stomach, negligible with food and calcium), so absorption of alendronate by a breastfed infant is unlikely.
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Because alendronate can persist in the body for years after long-term administration, the following cases may be relevant. A woman received alendronate for 6 months, then pamidronate every 4 months for 1 year prior to conception. Her infant was breastfed (extent not stated) for 3 months. The infant had mild hypocalcemia at 2 months of age, but a normal calcium level and normal long bone development at 5 months of age.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take alendronate while breastfeeding?
Limited evidence indicates that breastfeeding after cessation of long-term bisphosphonate treatment appears to have no adverse effects on the infant. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
What can I take instead of alendronate while breastfeeding?
LactMed lists Pamidronate as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does alendronate pass into breastmilk?
LactMed's measured drug levels for alendronate are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking alendronate?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on alendronate
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.