Can you take treprostinil 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.
The amount of treprostinil in milk appears to be low and it is not well absorbed orally. Two infants have been breastfed during maternal treprostinil therapy, one infant for one year, without any complications. However, until more data are available, treprostinil should be used with careful infant monitoring during breastfeeding.
Quoted from Treprostinil — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised May 15, 2025.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of treprostinil. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Bosentan
- Epoprostenol
- Nitric Oxide
- Sildenafil
How much treprostinil gets into breastmilk
Maternal Levels. A woman with pulmonary arterial hypertension received treprostinil by continuous infusion in a dose of 30 ng/kg per minute (2,352 ng/min), for 10 days postpartum. A milk sample taken at that time contained no detectable treprostinil (<0.05 mcg/L). The milk sample was frozen at -80 degrees C, which was subsequently found to reduce the concentration of treprostinil in milk by 16 to 18%. The average maternal serum concentration at that time was 2.2 mcg/L and unaffected by freezing. Treprostinil was changed to the subcutaneous route at the same dose and at 7 weeks postpartum, the average treprostinil concentration in milk that was immediately assayed and not frozen was 1.02 mcg/L and serum the average serum level was 5.65 mcg/L. Using the standard milk ingestion of 150 mL/kg daily, the relative infant dose would be 0.35%. Additionally, the oral bioavailability of treprostinil is only about 17%, for an effective RID of 0.06%.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
A woman developed pulmonary artery hypertension and was treated with intravenous treprostinil beginning at 32 weeks of gestation and titrated up to 26 ng/kg/min. The dose was nearly doubled postpartum because of worsening symptoms. She breastfed (extent not stated) her infant for one year with no apparent drug-related problems, although there was concern for obesity at 6 months of age. The infant was healthy and developing normally at 2 years of age.
A woman with pulmonary arterial hypertension initially received treprostinil by continuous infusion and then by subcutaneous injection in a dose of 30 ng/kg per minute (2,352 ng/min). She partially (extent not stated) breastfed her infant and at 7 weeks postpartum, no adverse effects were reported in her infant.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take treprostinil while breastfeeding?
The amount of treprostinil in milk appears to be low and it is not well absorbed orally. 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 treprostinil while breastfeeding?
LactMed lists Bosentan, Epoprostenol, Nitric Oxide, Sildenafil 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 treprostinil pass into breastmilk?
LactMed's measured drug levels for treprostinil are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking treprostinil?
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 treprostinil
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.