Is Sotalol Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Sotalol? Is Sotalol safe for nursing mother and child? Does Sotalol extracts into breast milk? Does Sotalol has any long term or short term side effects on infants? Can Sotalol influence milk supply or can 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 sotalol, especially while nursing a newborn or preterm infant. Some authors recommend using 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 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 sotalol.[6] Bradycardia was not seen in one 12-day-old infant who was breastfed from birth during maternal use of 600 mg of 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 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]