Diuretic
PREGNANCY RECOMMENDATION: Limited Human Data—Probably Compatible
BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible
PREGNANCY SUMMARY
The available pregnancy experience with bendroflumethiazide is limited. Nevertheless, the published experience with 1st trimester use of thiazides and related diuretics does not indicate these agents are teratogenic. One large study (the Collaborative Perinatal Project) did find an increased risk of defects when diuretics were used during the 1st trimester in women with cardiovascular disorders, but causal relationships cannot be inferred from these data without independent confirmation. (See Chlorothiazide.) Diuretics are not recommended for the treatment of gestational hypertension because of the maternal hypovolemia characteristic of this disease. Other risks to the fetus or newborn include hypoglycemia, thrombocytopenia, hyponatremia, hypokalemia, and death from maternal complications. Moreover, thiazide diuretics may have a direct effect on smooth muscle and inhibit labor.
FETAL RISK SUMMARY
Bendroflumethiazide is a thiazide diuretic. Animal reproduction studies during the period of organogenesis have not been conducted with this agent.
In a study reported in 1964, 1011 women received bendroflumethiazide, 5 mg/day, from 30 weeks’ gestation until delivery in an attempt to prevent preeclampsia and eclampsia (1). No fetal adverse effects were noted.
See Chlorothiazide for other reports of the clinical use of thiazide diuretics in pregnancy and the potential fetal and newborn toxicity of these agents.
BREASTFEEDING SUMMARY
Bendroflumethiazide has been used to suppress lactation (see Chlorothiazide) (2). The American Academy of Pediatrics classifies bendroflumethiazide as compatible with breastfeeding (3).
References
1.Cuadros A, Tatum HJ. The prophylactic and therapeutic use of bendroflumethiazide in pregnancy. Am J Obstet Gynecol 1964;89:891–7.
2.Healy M. Suppressing lactation with oral diuretics. Lancet 1961;1:1353–4.
3.Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108:776–89.