Is RP 21823 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use RP 21823? Is RP 21823 safe for nursing mother and child? Does RP 21823 extracts into breast milk? Does RP 21823 has any long term or short term side effects on infants? Can RP 21823 influence milk supply or can RP 21823 decrease milk supply in lactating mothers?

• DrLact safety Score for RP 21823 is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of RP 21823 may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that RP 21823 may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using RP 21823 .
• It is recommended to evaluate the advantage of not breastfeeding while using RP 21823 Vs not using RP 21823 And continue breastfeeding.
• While using RP 21823 Its must to monitor child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
• Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Drug is secreted in high amount into breast milk. Several cases have been published that did not report side effects in nursing babies, however, hypotension, bradicardia and tachypnea were found in one newborn.

Because of the relatively extensive excretion of RP 21823 and its active metabolite diacetolol into breastmilk and their extensive renal excretion, other agents may be preferred, especially while nursing a newborn or preterm infant.[1][2][3]

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. One mother reported no adverse effects in her breastfed infant (age unstated) during RP 21823 use.[8] Hypotension, bradycardia, and transient tachypnea occurred in a newborn infant, probably because of RP 21823 and diacetolol in breastmilk. The mother was taking 400 mg/day of RP 21823 and had renal impairment. Two other neonates in this report who were breastfed had no adverse reactions noted.[1]

Relevant published information on the effects of beta-blockade or RP 21823 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.[9]