Document Detail


Breast-feeding during maternal use of azathioprine.
MedLine Citation:
PMID:  17132809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report the clinical outcome of infants whose mothers were taking azathioprine while nursing and to quantify the transfer of 6-mercaptopurine (6-MP), its active metabolite, into breast milk. CASE SUMMARY: We report on a series of 4 patients treated with azathioprine while lactating. Breast milk samples were analyzed for 6-MP in 2 of the mothers. Several milk samples per patient were analyzed; levels of 6-MP were undetectable by high performance liquid chromatography (limit of detection 5 ng/mL). Therefore, the absolute relative infant dose would have been less than 0.09% of the maternal weight-adjusted dose. No adverse effects were encountered in any of the 4 infants. DISCUSSION: A large number of women of reproductive age are treated with azathioprine for a range of chronic conditions that require immunosuppression, such as systemic lupus erythematosus or solid organ transplants. Similar to other antimetabolites, the drug has generally been contraindicated for use during breast-feeding because of the theoretical concern for toxicity in the nursing infant. The available literature in this area is sparse and dated. The data presented here confirm published reports of minimal 6-MP excretion into milk, suggesting that significant systemic adverse effects in the infant are unlikely. CONCLUSIONS: Maternal azathioprine use during lactation does not appear to pose a significant immediate clinical risk to the suckling infant. Continued monitoring and long-term assessment of these infants are warranted.
Authors:
Myla E Moretti; Zul Verjee; Shinya Ito; Gideon Koren
Related Documents :
7282599 - The content, binding, and forms of vitamin b12 in milk.
11132769 - Soluble form of icam-1, vcam-1, e- and l-selectin in human milk.
1984349 - Lysozyme, lactoferrin, and secretory immunoglobulin a content in breast milk: influence...
19929699 - Design and characterization of a human milk product for the preterm infant.
8237869 - Selenium status of infants is influenced by supplementation of formula or maternal diets.
11115039 - Choice of formula and human milk supplement for preterm infants in australia.
10849229 - The drug epidemic: effects on newborn infants and health resource consumption at a tert...
15568689 - Characterization of allegedly musk-containing medicinal products in taiwan.
16695919 - Renal bicarbonate reabsorption and hydrogen ion excretion in normal infants.
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-11-28
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  40     ISSN:  1542-6270     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-13     Completed Date:  2007-01-08     Revised Date:  2007-05-02    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2269-72     Citation Subset:  IM    
Affiliation:
The Motherisk Program and Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada. momrisk@sickkids.ca
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Azathioprine / analysis*,  pharmacology,  therapeutic use*
Breast Feeding*
Female
Humans
Infant
Infant, Newborn
Milk, Human / chemistry*,  drug effects
Monitoring, Physiologic / methods
Chemical
Reg. No./Substance:
446-86-6/Azathioprine
Comments/Corrections
Comment In:
Ann Pharmacother. 2007 Apr;41(4):719-20; author reply 720   [PMID:  17389671 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Androgen deprivation in veterans with prostate cancer: implications for skeletal health.
Next Document:  Febuxostat: a selective xanthine oxidase inhibitor for the treatment of hyperuricemia and gout.