Duloxetine transfer across the placenta during pregnancy and into milk during lactation
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Philip M. Boyce, L. Peter Hackett , Kenneth F. Ilett
- چاپ و سال / کشور: 2011
Description
Objective Duloxetine is an efficacious antidepressant; however, its safety during the perinatal period is uncertain. The objective of this study was to assess the transfer across the placenta and provide data on infant exposure to duloxetine via breast milk. Methods A multiparous 31-year-old woman with recurrent melancholic depression had responded poorly to previous antidepressants, but had a full remission on duloxetine. She elected to remain on duloxetine for her third pregnancy and while breastfeeding. She gave birth to a healthy terminfant and there were no adverse events noted for the infant exposed to duloxetine.Duloxetine concentration wasmeasured chromatographically in maternal and infant serumcollected at birth, and in maternal milk and plasma and infant plasma 18 days later, (C/M) concentration ratio was calculated. Absolute and relative infant doses via milk were estimated and the percent drug in infant versus mother’s plasma was calculated. Results Cord/maternal serum concentration ratio for duloxetine was 0.12. Absolute infant dose via milk was 7.6 μg/L and relative infant dose was 0.81%. The ratio of drug in the infant’s plasma to that in maternal plasma during lactation also gave a 0.82% infant exposure estimate. Conclusions The low C/M ratio suggests a limited transfer across the placenta. The relative infant dose via milk was low by comparison to most other antidepressants, and this estimate confirmed the amount of drug in infant plasma during lactation. Our data suggest that duloxetine may be used in pregnancy and lactation for selected patients in whom other antidepressants have not been successful.
Arch Womens Ment Health (2011) 14:169–172 Received: 13 May 2010 / Accepted: 3 February 2011 / Published online: 27 February 2011 # Springer-Verlag 2011
