Is Amlodipine Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Amlodipine? Is Amlodipine safe for nursing mother and child? Does Amlodipine extracts into breast milk? Does Amlodipine has any long term or short term side effects on infants? Can Amlodipine influence milk supply or can Amlodipine decrease milk supply in lactating mothers?

It is excreted into breast milk in small amount (less than 10% of relative dose) without problems observed in infants whose mothers were on treatment with this drug. (Naito 2015, Ahn 2007)When measured, the plasma levels of drug in these infants were undetectable (Vasa 2013). Because its drug elimination period is very prolonged, an alternative drug known to be safer should be used, especially during the neonatal period and in case of premature infant.

Limited information indicates that milk levels of amlodipine are usually low and plasma levels in breastfed infants are undetectable. Maternal use of amlodipine during breastfeeding has not caused any adverse effects in breastfed infants. If amlodipine is required by the mother, it is not a reason to discontinue breastfeeding.

A woman took amlodipine for hypertension 5 mg daily beginning 2 weeks postpartum. Her exclusively breastfed infant was examined regularly and at 3 months of age was healthy and had normal physical and neurological development.[5] One woman received amlodipine 2.5 mg orally twice daily during pregnancy for hypertension associated with glomerulonephritis. The dose was increased to 5 mg twice daily on day 2 postpartum. Her exclusively breastfed infant's growth was normal throughout the first year of life and no adverse effects were noted.[6] A preterm infant of 32 weeks gestation was breastfed exclusively from day 7 to day 20 postpartum. The infant's mother was taking amlodipine and labetalol in unspecified dosages for hypertension. The infant had apnea episodes unrelated to amlodipine. Growth at 2 months of age was slightly low.[4] Thirty-one women with pregnancy-induced hypertension postpartum received amlodipine 5 mg daily by mouth, with the dosage increased as needed to maintain blood pressure of 140/90 mm Hg or less. Their breastfed (extent not stated) infants exhibited no observed adverse cardiovascular effects within 3 weeks postpartum, although exact measurement methods were not stated.[1]