Is Apo-Frusemide Safe in Breastfeeding

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

Diuretic drug with action on the Henle's loop of the nephron. At latest update, relevant published data on excretion into breast milk were not found. Its high protein-binding capacity makes excretion into breast milk in significant amount unlikely. Because of a low oral bioavailability, mostly in the neonatal period, absorption from the ingested milk is thought to be minimal. Long-term treatment with diuretic drugs, particularly Thiazides with long-lasting effect and action on the Henle's loop, may inhibit lactation. Apo-Frusemide has been used along with water restriction for inhibition of lactation. Because of this, diuretic drugs well established as safe should be preferred while breastfeeding, especially during the first post-natal months. Whenever used, close attention should be paid to milk production.

Because little information is available on the use of Apo-Frusemide during breastfeeding and because intense diuresis might decrease lactation, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

Anecdotal, short-term observations at one medical center found no adverse infant effects from maternal use of Apo-Frusemide in the immediate postpartum period.[1]

Apo-Frusemide 20 mg intramuscularly on the first postpartum day followed by 40 mg orally for 4 days has been used in conjunction with fluid restriction and breast binding to suppress lactation within 3 days postpartum.[2] The added contribution of Apo-Frusemide to fluid restriction and breast binding, which are effective in suppressing lactation, is not known. No data exist on the effects of loop diuretics on established lactation.