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Cosopt and Breastfeeding

A healthcare provider may decide that a woman who is breastfeeding can use Cosopt (dorzolamide/timolol), even though the manufacturer does not recommend this. Although one of the active ingredients in Cosopt does pass through breast milk even when used as an eye drop, the risk to the infant is likely quite low.

Can Breastfeeding Women Use Cosopt?

At least one of the active ingredients in Cosopt® (dorzolamide/timolol) passes through breast milk in humans. The manufacturer recommends that this medication be avoided in breastfeeding women. If you are breastfeeding a child, you should talk with your healthcare provider before using Cosopt.
 

Safety Issues With Cosopt and Breastfeeding

No studies have been done to see if dorzolamide (one of the active ingredients in Cosopt) passes through breast milk in humans. When exceptionally large doses of the drug were given by mouth to breastfeeding rats, the offspring showed poor weight gain. It should be noted that the doses used were 94 times the equivalent eye dosage in humans.
 
The other ingredient in Cosopt (timolol) does pass through breast milk, even if timolol is taken as an eye drop. Serious problems (such as a dangerously low heart rate or low blood pressure) could occur in the nursing infant. Therefore, if your healthcare provider decides that it is okay for you to take timolol while breastfeeding, your infant should be monitored to make sure that no serious problems occur.
 
In general, taking timolol eye drops is considered much safer for use while breastfeeding than taking timolol tablets. Using the eye drops results in much lower amounts of the drug being passed through breast milk.
 
Keep in mind that even though Cosopt is an eye drop, some of the medication may enter the bloodstream and could therefore possibly pass through breast milk. With normal use of Cosopt, it is unlikely that a large amount of the drug would reach the breast milk.
 
However, the possibility of problems cannot be entirely eliminated, since this medication has never been studied in breastfeeding women. If your healthcare provider recommends taking Cosopt while breastfeeding, be sure to watch for any side effects in your child.
 
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