Is Atorvastatin Safe in Breastfeeding

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

• DrLact safety Score for Atorvastatin is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Atorvastatin may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Atorvastatin may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using Atorvastatin .
• It is recommended to evaluate the advantage of not breastfeeding while using Atorvastatin Vs not using Atorvastatin And continue breastfeeding.
• While using Atorvastatin Its must to monitor 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.

Statins work by blocking cholesterol synthesis. At latest update no published data on breastfeeding were found. A high plasma protein-binding capacity makes it unlikely its passage into milk.Their low oral bioavailability hinders the passage toward infant’s plasma from ingested mother’s milk, except in preterm infants and immediate neonatal period, in which the infant may have an increased intestinal permeability. It is unknown whether it is capable of altering the lipid composition of milk, albeit it is known and that the infants need to ingest high amounts of cholesterol because it is essential for a proper development of cell membranes of the nervous system and as a precursor of various hormones and vitamins. It is prudent to avoid its use, at least while breastfeeding is exclusive. Atorvastatin is possibly the safest statin drug, for its high molecular weight makes it even more difficult the passage into the milk. With Pravastatin a poor secretion into milk has been reported. Simvastatin is the one with lowest oral bioavailability. Discontinuing the treatment of hypercholesterolemia during lactation with such kind of drugs will not likely alter the long-term outcome of the disease. A low-fat diet should be recommended.

The consensus opinion is that women taking a statin should not breastfeed because of a concern with disruption of infant lipid metabolism. However, others have argued that children homozygous for familial hypercholesterolemia are treated with statins beginning at 1 year of age, that statins have low oral bioavailability, and risks to the breastfed infant are low, especially with rosuvastatin and pravastatin.[1] Some evidence indicates that atorvastatin can be taken by nursing mothers with no obvious developmental problems in their infants. Until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

In a case series of patients with homozygous familial hypercholesterolaemia, 6 patients breastfed 11 infants after restarting statin therapy postpartum. The specific statin used by these women was not reported, most of the women on statin therapy were using atorvastatin, either 40 or 80 mg, daily. Normal early child development was reported for all offspring. Children started school at the appropriate age and no learning difficulties were reported.[2]