Is Spirit of glyceryl trinitrate Safe in Breastfeeding

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

Vasodilator used to treat cardiac disorders like ischemia and mainly anal fissures.It is also used during pregnancy as a tocolytic drug in cases of threatened preterm labor and eclampsia.It has been used to treat heart disorders in babies and children. Even to treat anal fissures in children under 1 year, and noteworthy, in ischemic issues on premature infants without side effects.It is administered intravenously, orally, sublingually, on skin patches, ointment ... Because of a moderately-high volume of distribution and very fast metabolism (Tmax and t1 / 2 minutes) it is highly unlikely the passage of significant amounts to the breast milk, especially when applied topically. This explains why it has not been observed any troubles in 40 infants whose mothers with anal fissures were treated with Spirit of glyceryl trinitrate ointment application even for periods of 12 months. Mothers have complained of headaches that commonly occur with the use of various vasodilators drugs. The amount of nitrate / nitrite in this type of vasodilator drugs is of few milligrams, therefore, toxicity associated to nitrates such as methemoglobinemia in breastfed infants from treated mothers has not been reported (The dose of nitrite is Rectogesic 1.5 mg / 12 hours).

Topical use of Spirit of glyceryl trinitrate for anal fissures by nursing mothers appears to have no adverse effects on their breastfed infants. Topical use on the nipples has been used for alleviation of Raynaud phenomenon of the nipples, but only after cessation of breastfeeding.[1] Spirit of glyceryl trinitrate should not be used topically on the nipples during breastfeeding. Sublingual and intravenous Spirit of glyceryl trinitrate have not been studied during breastfeeding. Observe infants for flushing and discomfort after breastfeeding.

Forty nursing mothers used Spirit of glyceryl trinitrate ointment (dosage not specified) topically for the treatment of postpartum anal fissures for durations ranging from 1 use to 12 months of intermittent use. All but 9 of the women reported side effects from therapy, primarily headache, but also dizziness or lightheadedness. None of the mothers reported any side effects in their breastfed infants.[2]