Can you take digoxin 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 the low levels of digoxin in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. If the mother is to receive digoxin intravenously, avoidance of breastfeeding for 2 hours after the dose will lessen the dose the infant receives.
Quoted from Digoxin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised September 15, 2024.
How much digoxin gets into breastmilk
Maternal Levels. In 11 women taking digoxin 0.25 mg daily orally, milk digoxin levels obtained on days 3 to 7 postpartum were relatively constant at 0.644 mcg/L. The amounts in milk represent an infant dosage of about 2.3% of the maternal weight-adjusted dosage or 0.097 mcg/kg daily, which is about 1% of the neonatal maintenance dosage.
Milk digoxin levels were 0.41 and 0.78 mcg/L in two mothers taking oral digoxin 0.25 mg daily.
Milk digoxin levels ranged from undetectable (<0.5 mcg/L) to 1 mcg/L in 5 women treated with unspecified doses of digoxin. Milk and serum levels were similar.
A milk digoxin level of 1.9 mcg/L was measured in a mother taking 0.75 mg daily of digoxin during pregnancy and postpartum.
After an intravenous bolus dose of digoxin 0.5 mg in 11 women, digoxin serum and milk levels rapidly equilibrated, with high levels occurring rapidly, dropping to low levels by about 2 hours after the dose. A pharmacokinetic simulation using data from these mothers indicate that a fully breastfed infant would obtain a serum level of only about 3% of a therapeutic level with maternal intake of 0.5 mg daily of digoxin.
Infant Levels. In two breastfed infants whose mothers were taking oral digoxin 0.25 mg daily, digoxin was undetectable (< 0.1 mcg/L) in their serum after 10 days of maternal therapy.
A mother took 0.75 mg daily of digoxin during pregnancy and postpartum. Her infant had a serum level of 0.2 mcg/L after nursing for 7 days, having decreased from a level of 0.6 mcg/L at birth.
What has been seen in breastfed infants
At least 4 infants have been reported to have been breastfed in studies on digoxin in breastmilk. None had any detectable digoxin effect.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take digoxin while breastfeeding?
What the NIH's Drugs and Lactation Database says about Digoxin 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.
Does digoxin pass into breastmilk?
LactMed's measured drug levels for digoxin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking digoxin?
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 digoxin
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.