Document Detail

Topiramate kinetics during delivery, lactation, and in the neonate: preliminary observations.
MedLine Citation:
PMID:  12366729     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To study the pharmacokinetics of topiramate (TPM) during delivery, lactation, and in the neonate.
METHODS: TPM concentrations in plasma and breast milk were measured with fluorescence polarization immunoassay (FPIA) in five women with epilepsy treated with TPM during pregnancy and lactation. Blood samples were obtained at delivery from mothers, from the umbilical cord, and from the newborns on three occasions (24, 48, and 72 h) after delivery. Blood and breast milk also were collected from mothers 2 weeks, and 1 and 3 months postpartum. Blood samples also were drawn from the infants during breast-feeding. Three of the mother-infant pairs were studied both at delivery and during lactation; two contributed with data from delivery only.
RESULTS: The umbilical cord plasma/maternal plasma ratios were close to unity, suggesting extensive transplacental transfer of TPM. The mean milk/maternal plasma concentration ratio was 0.86 (range, 0.67-1.1) at 2-3 weeks after delivery. The milk/maternal plasma concentration ratios at sampling 1 and 3 months after delivery were similar (0.86 and 0.69, respectively). Two to 3 weeks after delivery, two of the breast-fed infants had detectable (>0.9 microM) concentrations of TPM, although below the limit of quantification (2.8 microM), and one had an undetectable concentration.
CONCLUSIONS: Our limited data suggest free passage of TPM over the placenta and an extensive transfer into breast milk. Breast-fed infants had very low TPM concentrations, and no adverse effects were observed in the infants.
Inger Ohman; Sigurd Vitols; Gerhard Luef; Birgitta Söderfeldt; Torbjörn Tomson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epilepsia     Volume:  43     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-07     Completed Date:  2002-11-25     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1157-60     Citation Subset:  IM    
Departments of Internal Medicine, Division of Clinical Pharmacology and Clinical Neuroscience, Karolinska Hospital, and Department of Neuroscience and Locomotion, Linköping University, Stockholm and Linköping, Sweden.
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MeSH Terms
Anticonvulsants / pharmacokinetics*,  therapeutic use
Breast Feeding
Delivery, Obstetric*
Epilepsy / blood,  drug therapy*,  metabolism*
Fetal Blood / drug effects,  metabolism
Fluorescence Polarization Immunoassay
Fructose / analogs & derivatives*,  pharmacokinetics*,  therapeutic use
Infant, Newborn / blood*
Lactation / drug effects,  metabolism*
Maternal-Fetal Exchange
Milk, Human / drug effects,  metabolism
Pregnancy Complications / drug therapy*,  metabolism*
Reg. No./Substance:
0/Anticonvulsants; 0H73WJJ391/topiramate; 30237-26-4/Fructose

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

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