Is Acide alendronique [INN-French] Safe in Breastfeeding

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

It is composed by bisphosphonates. Most bisphosphonates are acidic compounds that achieve low plasma concentration. Both features make it unlikely excretion into the milk in clinically significant amount. Acide alendronique [INN-French] has shown very low plasma concentrations (<5 ng / ml). Intestinal absorption of bisphosphonates is very low even during fasting and is considered negligible in the presence of milk due to formation with the calcium of non absorbable compounds. A latest update no published data were found on excretion in the breast milk. Until more data about this drug regarding breastfeeding is available, safer known alternatives (e.g. pamidronate) should be of choice, especially in the neonatal period and in case of prematurity.

Limited evidence indicates that breastfeeding after cessation of long-term bisphosphonate treatment appears to have no adverse effects on the infant. Because no information is available on the use of Acide alendronique [INN-French] during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. However, absorption of Acide alendronique [INN-French] by a breastfed infant is unlikely. If the mother receives a bisphosphonate during pregnancy or nursing, some experts recommend monitoring the infant's serum calcium during the first 2 months postpartum.[1]

Because Acide alendronique [INN-French] can persist in the body for years after long-term administration, the following cases may be relevant. A woman received Acide alendronique [INN-French] for 6 months, then pamidronate every 4 months for 1 year prior to conception. Her infant was breastfed (extent not stated) for 3 months. The infant had mild hypocalcemia at 2 months of age, but a normal calcium level and normal long bone development at 5 months of age.[2]