title: The Difficulties in Antihypertensive Drug Prescription During Lactation: Is the Information Consistent?
abstract: BACKGROUND
  The lack of consistent official information on the use of medications during lactation is probably one of the main reasons leading to an excess of prudence, based on presumption of risk rather than on evidence. The objective of this study was to compare the level of agreement between different official sources available to doctors and women on the use of medications during lactation.
  
  
  METHODS
  Sources of information included governmental regulatory agencies (RAs) and scientific sources (SS). The package leaflets (PLs) and summaries of product characteristics (SPCs) were retrieved from online databases of the European Union and U.S. RAs. Among the SS, the latest edition of the book Medications and Mothers' Milk by Hale and Rowe and the LactMed database were selected. Information about the use of 11 antihypertensive medications during breastfeeding was analyzed.
  
  
  RESULTS
  The PLs and SPCs report a higher risk profile than the one expressed by SS, and they often suggest the interruption of lactation even for compatible medications.
  
  
  CONCLUSIONS
  Health professionals should be supported by official, accurate, comprehensive, and consistent information about maternally ingested medication and breastfeeding management to facilitate proper decision-making.
authors.affiliation: 1 Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy .
authors.forename: Sofia
authors.initials: S
authors.lastname: Colaceci
authors.affiliation: 2 National Center of Epidemiology, Surveillance, and Health Promotion, National Institute of Health , Rome, Italy .
authors.forename: Angela
authors.initials: A
authors.lastname: Giusti
authors.affiliation: 3 Baby Friendly Initiatives Italian National Committee for UNICEF , Rome, Italy .
authors.forename: Elise Merrill
authors.initials: EM
authors.lastname: Chapin
authors.affiliation: 4 Private Lactation Consultant Practice , Lerici, La Spezia, Italy .
authors.forename: Micaela
authors.initials: M
authors.lastname: Notarangelo
authors.affiliation: 1 Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy .
authors.forename: Alessia
authors.initials: A
authors.lastname: De Angelis
authors.affiliation: 1 Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy .
authors.forename: Ercole
authors.initials: E
authors.lastname: Vellone
authors.affiliation: 1 Department of Biomedicine and Prevention, University of Rome Tor Vergata , Rome, Italy .
authors.forename: Rosaria
authors.initials: R
authors.lastname: Alvaro
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001942:Breast Feeding; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007231:Infant, Newborn; D007774:Lactation / Q000187:drug effects*; D018811:Maternal Exposure / Q000009:adverse effects*; D008895:Milk, Human / Q000187:drug effects*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D055553:Prescription Drugs / Q000008:administration & dosage / Q000493:pharmacokinetics*; D014481:United States
chemical_list: D000959:Antihypertensive Agents; D055553:Prescription Drugs