Drugs in Pregnancy and Lactation: Tenth Edition

FENOLDOPAM

Antihypertensive

PREGNANCY RECOMMENDATION: No Human Data—Animal Data Suggest Low Risk

BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible

PREGNANCY SUMMARY

The absence of human pregnancy experience prevents an assessment of the fetal risk from exposure to fenoldopam mesylate, but the animal data are reassuring. Because it is used for the emergency reduction of severe hypertension, the maternal benefit probably outweighs the unknown fetal risk. However, rapid reduction of maternal blood pressure may compromise the placental perfusion, resulting in fetal hypoxia and subsequent bradycardia. Fetal death is a potential consequence of this effect. Fetal heart rate monitoring, therefore, is recommended during IV infusions of fenoldopam.

FETAL RISK SUMMARY

An IV infusion of fenoldopam mesylate, a dopamine D1-like receptor agonist, is indicated for the short-term (up to 48 hours), rapid-onset, management of severe hypertension. It is a vasodilator, affecting coronary, renal, mesenteric, and peripheral arteries in animals.

Reproduction studies have been conducted in rats and rabbits with oral doses up to 200 mg/kg/day and 25 mg/kg/day, respectively (1). Although maternal toxicity was evident at the highest doses, no evidence of impaired fertility or fetal harm was observed.

It is not known if fenoldopam mesylate crosses the human placenta. The molecular weight (about 402) is low enough that transfer to the fetus should be expected.

BREASTFEEDING SUMMARY

No reports describing the use of fenoldopam mesylate in human lactation have been located. The molecular weight (about 402) suggests that excretion into breast milk probably occurs. The effect of this exposure on a nursing infant is unknown. Because of the nature of the indication, opportunities for use of this drug during breastfeeding are probably very rare.

Reference

1.Product information. Corlopam. Abbott Laboratories, 2001.