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Topical timolol and the nursing mother
Archives of Ophthalmology (Chicago, Ill. : 1960)
|September 1, 1983
Summary
Timolol maleate, a glaucoma medication, was found in breast milk at higher levels than in plasma. Nursing mothers should use timolol with caution due to potential infant exposure.
Area of Science:
- Ophthalmology
- Pharmacology
- Lactation Studies
Background:
- Elevated intraocular pressure (IOP) management often involves topical medications.
- Timolol maleate is a commonly prescribed beta-blocker for glaucoma.
- The transfer of topical medications into breast milk is a critical consideration for nursing mothers.
Observation:
- A nursing woman with elevated IOP self-administered 0.5% timolol maleate to her right eye.
- Breast milk and plasma samples were collected 1.5 hours post-administration.
- Control milk samples were analyzed for baseline timolol levels.
Findings:
- Timolol levels in breast milk (5.6 ng/mL) were significantly higher than in plasma (0.93 ng/mL) 1.5 hours after administration.
- No measurable timolol was detected in control milk specimens.
- Detectable levels of timolol (0.5 ng/mL) persisted in milk 12 hours after the last dose.
Implications:
- Topical timolol maleate can transfer into breast milk at concentrations potentially higher than maternal plasma.
- This case highlights the importance of considering drug transfer into breast milk for nursing mothers using glaucoma medications.
- Caution is advised when prescribing or using timolol maleate in breastfeeding patients to minimize infant exposure.