To Luann Smith...Re: Calcium channel blockers The CCB's are really under pressure now, particularly since the data seems to suggest that they increase morbidity/mortality in hypertensive patients(this story is yet to be proven). The whole story is that they are very useful in some patients(particularly elderly) who do not do so well on beta blocker antihypertensives. Nevertheless, neither verapamil or nifedipine attain very high levels in breast milk, probably somewhere less than 0.01%(verapamil) to < 5%(nifedipine) of the maternal dose is transferred daily to the infant. Because both of these products have relatively short half-lives, they are administered in prolonged release formulations, which does away with trying to breastfeed around the peak level. The verapamil was not detectible in milk. However, if used in moderation, and if the infants' blood pressure were occassionally monitored the first few weeks of therapy, these agents can be used safely by breastfeeding moms. Just watch the infant for hypotension and bradycardia. One important note however, CCBs in overdose are incredibly dangerous. Several deaths have been reported by as few as 1-3 tablets in infants. Please keep these formulations out of the reach of children and use child-protective caps. Check your granny's house as well. Treatment of CCB overdose is almost impossible, and often fails. Lets be careful. To all those interested, I'll be unable to answer questions this next week, I'll be gone to the Toxicology Meetings in Rochester until the 20th. twh *********************************** T.W. Hale, Ph.D. Associate Professor of Pediatrics Texas Tech University School of Medicine ***********************************