Can you take betaxolol 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.
Because of its relatively extensive excretion into breastmilk and minimal reported experience during breastfeeding, other beta-blocking agents may be preferred for systemic use, especially while nursing a newborn or preterm infant.
Ophthalmic use of betaxolol by the mother should pose little risk to the breastfed infant, although some guidelines state that gel formulations are preferred over solutions. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
Quoted from Betaxolol — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised October 15, 2024.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of betaxolol. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much betaxolol gets into breastmilk
The excretion of beta-adrenergic blocking drugs into breastmilk is largely determined by their protein binding. Those with low binding are more extensively excreted into breastmilk. Accumulation of the drugs in the infant is related to the fraction excreted in urine. With 50% protein binding, 15% renal excretion and a long half-life, betaxolol presents a moderate risk for accumulation in infants, especially neonates.
Maternal Levels. Three mothers who received 10 mg of betaxolol orally before delivering their infant had postpartum colostrum betaxolol levels measured. In one woman who had one dose 3 hours prior to delivery, colostrum levels were 48 mcg/L 24 hours postpartum, 13 mcg/L 48 hours postpartum and 3 mcg/L 72 hours postpartum. Another woman who received a dose 25 hours before delivery had milk levels of 8.8 and 7 mcg/L 48 and 72 hours postpartum, respectively. A third woman who had a dose 26 hours before delivery had colostrum betaxolol levels of 7.8 and 4.2 mcg/L 24 and 48 hours postpartum, respectively. Each of these women had received only 1 or 2 doses of betaxolol before delivery, so steady state might not have been reached.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
A study of mothers taking beta-blockers during nursing found a numerically, but not statistically significant increased number of adverse reactions in those taking any beta-blocker. Although the ages of infants were matched to control infants, the ages of the affected infants were not stated. None of the mothers were taking betaxolol.
Beta-adrenergic blocking drugs with breastmilk excretion characteristics similar to betaxolol have caused adverse effects in breastfed newborns.
Effects on milk supply
Relevant published information on the effects of beta-blockade or betaxolol 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.
Frequently asked questions
Can you take betaxolol while breastfeeding?
What the NIH's Drugs and Lactation Database says about Betaxolol while breastfeeding — quoted in full. 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 betaxolol while breastfeeding?
LactMed lists Propranolol, Labetalol, Metoprolol, Levobunolol, Metipranolol, Timolol 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 betaxolol pass into breastmilk?
LactMed's measured drug levels for betaxolol are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking betaxolol?
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 betaxolol
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.