Nitroglycerin and Breastfeeding

Summary of use during lactation

Topical use of nitroglycerin for anal fissures by nursing mothers appears to have no adverse effects on their breastfed infants. Topical use on the nipples has been used for alleviation of Raynaud phenomenon of the nipples, but only after cessation of breastfeeding.[1] Nitroglycerin should not be used topically on the nipples during breastfeeding. Sublingual and intravenous nitroglycerin have not been studied during breastfeeding. Observe infants for flushing and discomfort after breastfeeding.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Forty nursing mothers used nitroglycerin ointment (dosage not specified) topically for the treatment of postpartum anal fissures for durations ranging from 1 use to 12 months of intermittent use. All but 9 of the women reported side effects from therapy, primarily headache, but also dizziness or lightheadedness. None of the mothers reported any side effects in their breastfed infants.[2]

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

References

1. O'Sullivan S, Keith MP. Raynaud phenomenon of the nipple: A rare finding in rheumatology clinic. J Clin Rheumatol 2011;17:371-2.21946463 PubMed
2. Taylor T, Kennedy D. Safety of topical glyceryl trinitrate in the treatment of anal fissure in breastfeeding women. Birth Defects Res A Clin Mol Teratol 2008;82:411. doi:10.1002/bdra.20478