Question

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

Alendronic Acid lactation summary

Alendronic Acid usage has low risk in breastfeeding
  • DrLact safety Score for Alendronic Acid is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of Alendronic Acid may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that Alendronic Acid may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of Alendronic Acid low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using Alendronic Acid We suggest monitoring 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.

Answer by Dr. Ru: About Alendronic Acid usage in lactation

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. Alendronate 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.

Answer by DrLact: About Alendronic Acid usage in lactation

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 alendronate during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. However, absorption of alendronate 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]

Alendronic Acid Side Effects in Breastfeeding

Because alendronate can persist in the body for years after long-term administration, the following cases may be relevant. A woman received alendronate 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]
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. We do not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.