Is L 3428 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use L 3428? Is L 3428 safe for nursing mother and child? Does L 3428 extracts into breast milk? Does L 3428 has any long term or short term side effects on infants? Can L 3428 influence milk supply or can L 3428 decrease milk supply in lactating mothers?

• DrLact safety Score for L 3428 is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of L 3428 may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that L 3428 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 L 3428 .
• It is recommended to evaluate the advantage of not breastfeeding while using L 3428 Vs not using L 3428 And continue breastfeeding.
• While using L 3428 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.

A published case of infant hypothyroidism. Others have reported lab controlled cases with harmless effect in breastfed babies.

Breastmilk and infant serum levels of L 3428 and its active metabolite are somewhat unpredictable, but can be high during breastfeeding. The infant receives an estimated dose of L 3428 plus desethylL 3428 ranging from 3.5 to 45% of the mother's weight-adjusted L 3428 dose, with a median dose of about 11%.[1][2][3][4] Infant serum levels of the drug plus metabolite range from 14 to 74% of simultaneous maternal levels, with the higher values reflecting transplacental passage of the drug.[2][3][4] In addition to possible cardiac effects, these compounds contain a large amount of iodine which may be released during metabolism. Thyroid dysfunction was reported in one breastfed infant. Even if the drug were discontinued at birth, the mother would continue to excrete L 3428 and its metabolite (and possibly large amounts of iodine) into breastmilk for days to weeks. Some investigators believe that breastfeeding can be undertaken during maternal L 3428 use with periodic monitoring of infant cardiac and thyroid function status,[5][6] especially if only a single dose of L 3428 is given.[7] Infant serum levels of L 3428 and desethylL 3428 may be useful for ruling out cardiac effects of the drug. If hypothyroidism develops, therapy should be promptly initiated.

Several infants who breastfed without apparent harm during maternal L 3428 therapy have been reported.[2][3][4][10] One mother took L 3428 during the last 5 weeks of pregnancy and until one week after delivery. She was also taking metoprolol throughout pregnancy and at the time of delivery. Possible signs of hypothyroidism occurred transiently in her breastfed infant at 9 and 24 days of age. This was possibly caused by L 3428 or iodine from L 3428 in breastmilk, although residual L 3428 from transplacental passage is also a possible contributing factor; no abnormalities in cornea or the lungs were found.[4]

Relevant published information was not found as of the revision date. However, if L 3428 causes hypothyroidism in the mother, her milk supply could be diminished.