Document Detail


Tacrolimus Placental Transfer at Delivery and Neonatal Exposure through Breast Milk.
MedLine Citation:
PMID:  23528073     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM(S): The current investigation aims to provide new insights into fetal exposure to tacrolimus in utero by evaluating maternal and umbilical cord blood (venous and arterial), plasma and unbound concentrations at delivery. This study also presents a case report of tacrolimus excretion via breast milk. METHODS: Maternal and umbilical cord (venous and arterial) samples were obtained at delivery from eight solid organ allograft recipients to measure tacrolimus and metabolite bound and unbound concentrations in blood and plasma. Tacrolimus pharmacokinetics in breast milk were assessed in one subject. RESULTS: Mean (± SD) tacrolimus concentrations at the time of delivery in umbilical cord venous blood (6.6 ± 1.8 ng/mL) were 71 ± 18% (range 45-99%) of maternal concentrations (9.0 ± 3.4 ng/mL). The mean umbilical cord venous plasma (0.09 ± 0.04 ng/mL) and unbound drug concentrations (0.003 ± 0.001 ng/mL) were approximately one fifth of the respective maternal concentrations. Arterial umbilical cord blood concentrations of tacrolimus were 100 ± 12% of umbilical venous concentrations. In addition, infant exposure to tacrolimus through the breast milk was less than 0.3% of the mother's weight-adjusted dose. CONCLUSIONS: Differences between maternal and umbilical cord tacrolimus concentrations may be explained in part by placental P-gp function, greater red blood cell partitioning and higher hematocrit levels in venous cord blood. The neonatal drug exposure to tacrolimus via breast milk is very low and likely does not represent a health risk to the breastfeeding infant.
Authors:
Songmao Zheng; Thomas R Easterling; Karen Hays; Jason G Umans; Menachem Miodovnik; Shannon Clark; Justina C Calamia; Kenneth E Thummel; Danny D Shen; Connie L Davis; Mary F Hebert
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-26
Journal Detail:
Title:  British journal of clinical pharmacology     Volume:  -     ISSN:  1365-2125     ISO Abbreviation:  Br J Clin Pharmacol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503323     Medline TA:  Br J Clin Pharmacol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Authors. British Journal of Clinical Pharmacology © 2013 The British Pharmacological Society.
Affiliation:
Department of Pharmaceutics, University of Washington, Seattle, WA.
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