Is Linagliptin Safe in Breastfeeding

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

It promotes pancreatic insulin secretion by inhibiting the DPP-4 enzyme that degrades the GLP-1 and GIP intestinal hormones involved in the physiological regulation of glucose, which are activated by eating (EMA 2016, Baetta, 2011, Scheen 2011). Administered orally once a day. Very low risk of hypoglycemia in monotherapy. Very low frequency of clinically significant side effects. Dosage up to 120 times higher than normal did not produce side effects (EMA 2016). Since the last update we have not found published data on its excretion in breast milk. Its pharmacokinetic data (EMA 2016, Scheen 2011): high volume of distribution and high percentage of protein binding make it unlikely that significant amounts will pass into breast milk, but low molecular weight, low metabolism and its effective elimination half-life of 12 hours would facilitate its possible passing into breast milk. Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in case of prematurity. Diet, exercise, and breastfeeding improve blood sugar levels. Among the antidiabetics of this same group, saxagliptin and vildagliptin would be preferable due to their short half-life (less than 3 hours). See below the information of these related products:

No information is available on the clinical use of linagliptin during breastfeeding. Linagliptin's plasma protein binding ranges from 80% to over 99%, so it is unlikely to pass into breastmilk in clinically important amounts and might be a better choice among drugs in this class for nursing mothers. If linagliptin is required by the mother, it is not a reason to discontinue breastfeeding. However, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Monitor breastfed infants for signs of hypoglycemia such as jitteriness, excessive sleepiness, poor feeding, seizures cyanosis, apnea, or hypothermia. If there is concern, monitoring of the breastfed infant's blood glucose is advisable during maternal therapy with linagliptin.[1]