Summary of Use during Lactation

No information is available on the use of norepinephrine during breastfeeding. Because of its poor oral bioavailability and short half-life, any norepinephrine in milk is unlikely to affect the infant. High intravenous doses of norepinephrine might reduce milk production or milk letdown as well as decrease the concentration of beta-casein in milk.

Drug Levels

Maternal Levels. Eight nursing mothers collected breastmilk for analysis of norepinephrine. Milk norepinephrine levels ranged from 12.7 to 115.5 nanomolar (2.1 to 19.5 mcg/L). The norepinephrine in milk appears to be synthesized locally by mammary epithelial cells and actively secreted into milk.[1,2]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Norepinephrine inhibits the synthesis of beta-casein via stimulation of adrenergic beta-2 receptors.[1] Animal data indicate that norepinephrine can decrease serum prolactin and reduce milk production,[3] as well as inhibit the release of oxytocin, which inhibits milk ejection.[4]

References

1.

Chiba T, Maeda T, Fujita Y, et al. Stress-induced suppression of milk protein is involved in a noradrenergic mechanism in the mammary gland. Endocrinology. 2019;160:2074–84. [PubMed: 31150047]

2.

Chiba T, Takaguri A, Maeda T. Norepinephrine transporter expressed on mammary epithelial cells incorporates norepinephrine in milk into the cells. Biochem Biophys Res Commun. 2021;545:1–7. [PubMed: 33529804]

3.

Thomas GB, Cummins JT, Doughton BW, et al. Direct pituitary inhibition of prolactin secretion by dopamine and noradrenaline in sheep. J Endocrinol. 1989;123:393–402. [PubMed: 2607250]

4.

Song SL, Crowley WR, Grosvenor CE. Evidence for involvement of an adrenal catecholamine in the beta-adrenergic inhibition of oxytocin release in lactating rats. Brain Res. 1988;457:303–9. [PubMed: 2851365]

Substance Name

Norepinephrine

CAS Registry Number

51-41-2

Drug Class

Breast Feeding

Lactation

Adrenergic Agonists

Adrenergic Alpha-Agonists

Catecholamines

Sympathomimetics

Vasoconstrictor Agents