treating (non-infective) urinary disorders during breastfeeding

Oxybutynin is the preferred choice for treating urinary frequency, urgency and urge incontinence due to its favourable pharmacokinetic properties (1).

No information is available on the use of oxybutynin during breastfeeding (2):

• long-term use of oxybutynin might reduce milk production or milk letdown, but a single dose is not likely to interfere with breastfeedin
• during long-term use, observe for signs of decreased lactation (e.g., insatiety, poor weight gain)

Infant monitoring whilst on oxybutynin

• as a precaution, monitor the infant for potential side effects including drowsiness, insomnia, irritability, gastro-intestinal effects, urinary retention (decrease in wet nappies), dry mouth, poor feeding and adequate weight gain.
• monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine

Co-sleeping advice

• sudden infant death syndrome (SIDS) is very rare, and breastfeeding reduces the risk
  • however, it is much more likely to happen in certain circumstances, including when parents have taken sedating medicines (oxybutynin, duloxetine, tolterodine and solifenacin)

With respect to other agents used for treating urinary disorders (1)

Duloxetine

• can be used with caution during breastfeeding, but oxybutynin is preferred

Mirabegron

• can be used with caution during breastfeeding, but oxybutynin is preferred

Infant monitoring

• as a precaution, monitor the infant for potential side effects including drowsiness, irritability, gastrointestinal disturbances, urinary retention (decrease in wet nappies), dry mouth, poor feeding and adequate weight gain
• monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine

Additional information:

• is no published evidence of use during breastfeeding. Milk levels have not been measured
• based on its pharmacokinetic properties, it is likely to be found in breastmilk in low levels
  • its relatively low oral bioavailability will further limit absorption by the infant
  • although side effects are unlikely, mirabegron has a long half-life, increasing the risk of accumulation in the breastfed infant, which may increase the risk of side effects

Solifenacin

• can be used with caution during breastfeeding, but oxybutynin is preferred

Infant monitoring

• as a precaution, monitor the infant for potential side effects including drowsiness, irritability, gastrointestinal disturbances, urinary retention (decrease in wet nappies), dry mouth, poor feeding and adequate weight gain
• monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine

Additional information

• is no published evidence of use in breastfeeding. Milk levels have not been measured
• based on its pharmacokinetic properties, it is likely to be found in breastmilk in low levels
  • although side effects are unlikely, solifenacin has a long half-life, increasing the risk of accumulation in the breastfed infant which may increase the risk of side effects

Tolterodine

• can be used with caution during breastfeeding, but oxybutynin preferred.

Infant monitoring

• as a precaution, monitor the infant for potential side effects including drowsiness, irritability, gastrointestinal disturbances, urinary retention (decrease in wet nappies), dry mouth, poor feeding and adequate weight gain
• monitoring the infant will quickly pick up any potential issues but usually further investigation is required before the cause can be attributed to the medicine

Addtional information

• is no published evidence of use in breastfeeding. Milk levels have not been measured
• based on its pharmacokinetic properties, it is likely to be found in breastmilk in very low levels. Its low oral bioavailability will further limit absorption by the infant so, side effects are unlikely

Reference:

1. NHS Specialist Pharmacy Service (July 2nd 2026). Treating urinary disorders during breastfeeding
2. Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Oxybutinyn. [Updated 2018 Dec 3].