Atenolol During Pregnancy & Breastfeeding

by on May 4, 2012

Can Pregnant Women Take Atenolol?

The FDA classifies atenolol as a Pregnancy Category D medication which means that it can cause harm on the unborn child when used during pregnancy. Therefore, Atenolol should be used in pregnancy only if there are no alternatives and the perceived benefits outweigh the potential risks.

Atenolol passes the placenta which exposes the fetus to possible negative effects. Studies have shown that women who have taken atenolol (particularly during the second trimester) are at increased risk for delivering before term (less than 37 weeks). In addition, some studies have shown that taking atenolol during second trimester of pregnancy results in infants that are smaller for gestational age and with lower birth weight.

Meanwhile, fetal exposure to atenolol during the last months of pregnancy increases the infant’s risk for slow heart rate (bradycardia), low blood sugar (hypoglycemia) and low blood pressure (hypotension) immediately or several hours after delivery. Close monitoring is recommended for infants who have been exposed to atenolol during the last trimester of pregnancy.

Although there are no studies concerning the use of atenolol during the first three months of pregnancy, the possibility of fetal injury is relatively high. So, if you become pregnant while taking atenolol, be sure to contact your healthcare provider immediately. Your healthcare provider will evaluate potential hazard to the unborn child. Normally, your medication will be changed.

It is important to discuss with your healthcare provider any plans of becoming pregnant before starting this medication. You and your healthcare provider must evaluate the benefits and risk of using atenolol during pregnancy in order to come up with a shared decision.

Can Breastfeeding Women Take Atenolol?

Basically, atenolol is not recommended for breastfeeding women. This medication is excreted in the human milk and can cause unwanted effects on the nursing infant.

Atenolol tends to accumulate in the breast milk. Clinical studies reveal that breast milk contains atenolol at a ratio of 1.5 to 6.8 when compared to drug levels in plasma. This can result in the infant receiving potentially fatal atenolol doses. Infants who are breastfed by patients taking atenolol are at increased risk of developing adverse effects particularly hypotension, bradycardia and hypoglycemia. There are also rare cases of infants experiencing cyanosis (lack of circulation oxygen).

Consult your doctor if you are or will be breast-feeding while taking atenolol. Normally, your healthcare provider will substitute atenolol with another antihypertensive medication. However, if there are no alternatives and the benefits outweigh the potential risks, atenolol may be given. Regular physician visits are recommended if taking atenolol during pregnancy.