Is dl-Sotalol Safe in Breastfeeding

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

No adverse effects have been reported, but check-up for the possibility of sedation, hypotension, hypoglycemia or bradycardia.

Because of its extensive excretion into breastmilk, its renal excretion and minimal safety data in breastfed infants, other beta-adrenergic blocking drugs are preferred to dl-Sotalol, especially while nursing a newborn or preterm infant. Some authors recommend using dl-Sotalol during breastfeeding only while monitoring the infant closely for signs of beta-blockade.[1] Infants over 2 months of age have more mature kidney function and are less likely to be affected by dl-Sotalol in milk.

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 of the mothers was taking dl-Sotalol.[6] Bradycardia was not seen in one 12-day-old infant who was breastfed from birth during maternal use of 600 mg of dl-Sotalol daily.[4] In another breastfed infant whose mother was taking 80 mg 2 to 3 times daily for more than 3 months, no bradycardia was seen and developmental milestones were achieved normally.[1] Beta-adrenergic blocking drugs with similar breastmilk excretion characteristics and renal elimination have caused adverse effects in breastfed newborns.[7][8]

Relevant published information on the effects of beta-blockade or dl-Sotalol 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]