From the Guidelines
Carvedilol is recommended for lactating mothers at a starting dose of 2.5 mg twice daily, with a maximum dose of 25 mg twice daily, as it has limited safety data but is likely low risk. The Relative Infant Dose (RID) for Carvedilol is not explicitly stated in the study, but it is mentioned that it has limited safety data and is likely low risk 1. According to the study published in Circulation in 2025, the starting dose for Carvedilol is 2.5 mg twice daily, with a maximum dose of 25 mg twice daily 1. Some key points to consider when prescribing Carvedilol to lactating mothers include:
- Monitoring the infant for potential side effects such as drowsiness, lethargy, or poor feeding, although these are rare
- Taking the medication at the same times each day, preferably after breastfeeding to minimize infant exposure
- Gradually increasing the dose as needed based on blood pressure response
- Considering combination therapy with an angiotensin receptor blocker (ARB) in patients with mild reductions in left ventricular ejection fraction 1. It's essential to weigh the benefits and risks of Carvedilol in lactating mothers, and the current evidence suggests that it is a viable option for treating hypertension and heart failure in this population 1.
From the Research
Carvedilol Dosage for Lactating Mothers
- The recommended dose of Carvedilol for a lactating mother is not explicitly stated in the provided studies.
- However, according to the study 2, low dose beta-blockers such as propranolol do not pose enough of a risk to preclude breastfeeding.
- Another study 3 suggests that when prescribing medications for a breastfeeding patient, those with the lowest risk to the infant should be selected, and dosing should be before the infant's longest sleep interval.
- The study 4 provides information on the blood pressure lowering efficacy of dual alpha and beta blockers, including Carvedilol, but does not specifically address dosage for lactating mothers.
- It is essential to consult current, accurate resources, such as LactMed, to determine the safety of Carvedilol during lactation, as mentioned in the study 3.
- The study 5 emphasizes the importance of considering both disease and drug characteristics when making decisions on medication use during pregnancy and lactation, which can be applied to the use of Carvedilol in lactating mothers.