Can you take methyldopa 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 methyldopa in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. No special precautions are required.
Quoted from Methyldopa — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised November 15, 2024.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of methyldopa. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much methyldopa gets into breastmilk
Maternal Levels. Three women who were 2 to 15 days postpartum were taking 250 mg of methyldopa orally 3 or 4 times daily. Randomly drawn milk samples had levels of drug and conjugate that ranged from < 0.1 to 0.5 mg/L at a dose of 750 mg daily and were 0.8 mg/L at a dose of 1 gram daily.
In 3 women who were 1 to 8 weeks postpartum, peak levels of drug and conjugate occurred between 3 and 6 hours after the dose. Peak levels of drug and conjugate after a dose of 500 mg were 0.2, 0.66 and 1.14 mg/L in 3 mothers' milk. The authors estimated an infant dosage of less than 0.2% of the mother's total dosage.
Infant Levels. No methyldopa was detectable (<200 mcg/L) in the serum of an infant whose mother was taking methyldopa 250 mg twice daily. The infant's urine contained a methyldopa concentration of 3.8 mg/L.
In an 8-week-old infant whose mother was receiving 1 gram daily of methyldopa, a serum level of 90 mcg/L was found 10 hours after a 500 mg maternal dose. Another 1-week-old infant whose mother was receiving 500 mg daily had no detectable drug in the serum (<50 mcg/L).
What has been seen in breastfed infants
No acute or long-term adverse effects were reported in any 15 infants ranging in age from less than 1 week to 8 weeks of age whose mothers were taking oral methyldopa 0.25 to 1.5 grams daily.
Effects on milk supply
Methyldopa can increase serum prolactin and has caused galactorrhea. The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Frequently asked questions
Can you take methyldopa while breastfeeding?
What the NIH's Drugs and Lactation Database says about Methyldopa 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 methyldopa while breastfeeding?
LactMed lists Candesartan, Benazepril, Captopril, Enalapril, Lisinopril, Quinapril, Hydrochlorothiazide, Propranolol 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 methyldopa pass into breastmilk?
LactMed's measured drug levels for methyldopa are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking methyldopa?
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 methyldopa
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.