Can you take pindolol 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.
Recommendation for Use During Lactation: Limited information indicates that maternal pindolol produces low levels in milk. It also has a short half-life and only moderate renal excretion, so it would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months.
Quoted from Pindolol — 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 pindolol. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much pindolol 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 60% protein binding, 40% renal excretion and a half-life of 3 hours, pindolol presents moderately low risk for accumulation in infants. Pindolol is administered as a racemic mixture, but the (-)-S enantiomer has much more activity than the (+)-R enantiomer.
Maternal Levels. Three women were receiving pindolol 10 mg every 12 hours during pregnancy and postpartum. A single breastmilk sample was collected from each mother on the day of delivery at 11, 12 or 14 hours after the previous pindolol dose. The 2 pindolol enantiomers were measured separately in milk, with (-)-S-pindolol concentration averaging 3.1 mcg/L (range 1.5 to 3.9 mcg/L) and (+)-R-pindolol averaging 1.9 mcg/L (range 1.2 to 4.2 mcg/L). Using the AUC and milk/plasma ratio values reported, a fully breastfed infant would receive an average of 0.36% of the maternal weight-adjusted dosage of pindolol.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Relevant published information on pindolol was not found as of the revision date. 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 pindolol.
Effects on milk supply
Relevant published information on the effects of beta-blockade or pindolol 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 pindolol while breastfeeding?
Recommendation for Use During Lactation: Limited information indicates that maternal pindolol produces low levels in milk. 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 pindolol while breastfeeding?
LactMed lists Propranolol, Labetalol, Metoprolol 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 pindolol pass into breastmilk?
LactMed's measured drug levels for pindolol are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking pindolol?
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 pindolol
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.