Anticonvulsants and breast feeding: A critical review

被引：41

作者：

Bar-Oz B. ^{[1
,2
]}

Nulman I. ^{[2
]}

Koren G. ^{[2
,3
]}

Ito S. ^{[2
]}

机构：

[1] Department of Neonatology, Hadassah Medical Center, Jerusalem

[2] Motherisk Program, Div. of Clin. Pharmacol./Toxicology, University of Toronto, Toronto, Ont.

[3] Division of Clinical Pharmacology, Hospital for Sick Children, Toronto, Ont. M5G 1X8

来源：

Pediatric Drugs | 2000年 / 2卷 / 2期

关键词：

Carbamazepine; Valproic Acid; Breast Milk; Gabapentin; Lamotrigine;

D O I：

10.2165/00148581-200002020-00004

中图分类号：

学科分类号：

摘要：

Progress in the diagnosis and management of seizure disorders and the availability of effective anticonvulsive medications has enabled increasing numbers of epileptic women of child-bearing age to raise families. Breast feeding, which these women may wish to choose, provides health, nutritional, immunological, developmental, social, economic and environmental benefits. The traditional anticonvulsants, such as phenytoin, carbamazepine and valproic acid (valproate sodium), are generally considered safe for use during breast feeding; however, observation for adverse effects is recommended. The use of phenobarbital while breast feeding is controversial because of its slow elimination by the nursing infant. The newer anticonvulsants, such as clobazam, felbamate, gabapentin, lamotrigine, oxcarbazepine, tiagabine, topiramate, and vigabatrin, are used mainly as adjunctive therapy. Data on the use of these drugs in pregnancy and lactation, and regarding long term effects on cognition and behaviour, are sparse. Weighing the benefits of breast feeding against the potential risk to the nursing infant, breast feeding is considered to be safe when the mother is taking carbamazepine, valproic acid or phenytoin. Infant monitoring for potential adverse effects is advisable when the mother is taking phenobarbital, clobazam, gabapentin, lamotrigine, oxcarbazepine or vigabatrin. Monitoring of infant serum drug concentrations is advisable but not compulsory. The use of felbamate, tiagabine and topiramate during breast feeding should await further study.

引用

页码：113 / 126

页数：13

共 165 条

[21] Duncan B., Ey J., Holberg C.J., Et al., Exclusive breast-feeding for at least 4 months protects against otitis media, Pediatrics, 91, 5, pp. 867-872, (1993)
[22] Owen M.J., Baldwin C.D., Swank P.R., Et al., Relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion in the first two years of life, J Pediatr, 123, 5, pp. 702-711, (1993)
[23] Paradise J.L., Elster B.A., Tan L., Evidence in infants with cleft palate that breast milk protects against otitis media, Pediatrics, 94, 6 PART 1, pp. 853-860, (1994)
[24] Aniansson G., Alm B., Andersson B., Et al., A prospective cohort study on breast-feeding and otitis media in Swedish infants, Pediatr Infect Dis J, 13, 3, pp. 183-188, (1994)
[25] Lucas A., Cole T.J., Breast milk and neonatal necrotising enterocolitis, Lancet, 336, 8730, pp. 1519-1523, (1990)
[26] Covert R.F., Barman N., Domanico R.S., Et al., Prior enteral nutrition with human milk protects against intestinal perforation in infants who develop necrotizing enterocolitis, Pediatr Res, 37, (1995)
[27] Ito S., Moretti M., Liau M., Et al., Initiation and duration of breast-feeding in women receiving antiepileptics, Am J Obstet Gynecol, 172, 3, pp. 881-886, (1995)
[28] Bailey B., Ito S., Breast-feeding and maternal drug use, Pediatr Clin North Am, 44, 1, pp. 41-54, (1997)
[29] Begg E.J., Atkinson H.C., Duffull S.B., Prospective evaluation of a model for the prediction of milk: Plasma drug concentrations from physicochemical characteristics, Br J Clin Pharmacol, 33, 5, pp. 501-505, (1992)
[30] Ito S., Koren G., A novel index for expressing exposure of the infant to drugs in breast milk, Br J Clin Pharmacol, 38, 2, pp. 99-102, (1994)

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