作者sharkimage (生日那天的甜蜜 ~)
看板pharmacist
标题Re: [问题] 想请问cetirizine可用在哺乳吗
时间Thu Mar 20 02:03:12 2014
※ 引述《LEEDFITH (Mirror)》之铭言:
: 刚刚去哺乳协会查risk 0
: http://www.e-lactancia.org/product/322
: 但去PDR
: http://ppt.cc/VsRT
: 又说建议不要
: 看了仿单也不行
在妈宝版学到的一个资料库
美国国家医学资料库(National Library of Medicine,NLM)
中的药物与哺乳的资料库“Lactmed”
http://goo.gl/LKO5xh
我把查到的资料贴上
------------------------------------------------------------------------
Cetirizine
------------------------------------------------------------------------
CASRN: 83881-51-0
For other data, click on the Table of Contents
# Drug Levels and Effects:
> Summary of Use during Lactation:
Small occasional doses of cetirizine are probably acceptable during
breastfeeding.
Larger doses or more prolonged use may cause drowsiness and other effects
in the infant or decrease the milk supply, particularly in combination
with a sympathomimetic such as pseudoephedrine or before lactation is well
established.
The British Society for Allergy and Clinical Immunology recommends
cetirizine at its lowest dose as a preferred choice if an antihistamine is
required during breastfeeding.[1]
# Drug Levels:
> Maternal Levels.
Relevant published information was not found as of the revision date.
> Infant Levels.
Relevant published information was not found as of the revision date.
# Effects in Breastfed Infants:
In one telephone follow-up study, mothers reported irritability and colicky
symptoms 10% of infants exposed to various antihistamines and drowsiness was
reported in 1.6% of infants.
None of the reactions required medical attention.[2]
A woman who was nursing (extent not stated) her newborn infant was treated
for pemphigus with oral prednisolone 25 mg daily, with the dosage increased
over 2 weeks to 60 mg daily.
She was also taking cetirizine 10 mg daily and topical betamethasone 0.1%
twice daily to the lesions.
Because of a poor response, the betamethasone was changed to clobetasol
propionate ointment 0.05%.
She continued breastfeeding throughout treatment and her infant was developing
normally at 8 weeks of age and beyond.[3]
# Possible Effects on Lactation:
Antihistamines in relatively high doses given by injection can decrease basal
serum prolactin in nonlactating women and in early postpartum women.[4][5]
However, suckling-induced prolactin secretion is not affected by
antihistamine pretreatment of postpartum mothers.[4]
Whether lower oral doses of cetirizine have the same effect on serum prolactin
or whether the effects on prolactin have any consequences on breastfeeding
success have not been studied.
The prolactin level in a mother with established lactation may not affect her
ability to breastfeed.
# Alternate Drugs to Consider: Desloratadine, Fexofenadine, Loratadine
References:
1. Powell RJ, Du Toit GL, Siddique N et al. BSACI guidelines for the
management of chronic urticaria and angio-oedema. Clin Exp Allergy.
2007;37:631-50. PMID: 17456211
2. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse
reactions in breast-fed infants exposed to maternal medication. Am J Obstet
Gynecol. 1993;168:1393-9. PMID: 8498418
3. Westermann L, Hugel R, Meier M et al. Glucocorticosteroid-resistant
pemphigoid gestationis: successful treatment with adjuvant immunoadsorption.
J Dermatol. 2012;39:168-71. PMID: 22379622
4. Messinis IE, Souvatzoglou A, Fais N et al. Histamine H1 receptor
participation in the control of prolactin secretion in postpartum. J
Endocrinol Invest. 1985;8:143-6. PMID: 3928731
5. Pontiroli AE, De Castro e Silva E, Mazzoleni F et al. The effect of
histamine and H1 and H2 receptors on prolactin and luteinizing hormone
release in humans: sex differences and the role of stress. J Clin Endocrinol
Metab. 1981;52:924-8. PMID: 7228996
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1F:推 LEEDFITH:感谢~ grade of recommendation=C 感觉还是少用好? 03/20 15:54
2F:推 johnnyjaiu:收录在 z->5 05/07 12:42