毒理性
哺乳期使用概述：钙三醇是维生素D的正常生理活性形式，即1,25-二羟基维生素D。一些患有低钙血症的妇女在哺乳期间成功进行了哺乳，血清钙水平有时会波动。有限的数据表明，哺乳母亲在适当调整剂量下使用，不会影响哺乳婴儿。如果母亲需要钙三醇，这不是停止哺乳的理由。在患有低甲状旁腺功能的女性中，哺乳期间钙三醇和钙的剂量需求通常会降低。
对哺乳婴儿的影响：一名患有低甲状旁腺功能的妇女在服用钙三醇的情况下，从产后第1周到第32周对婴儿进行了哺乳。初始剂量为每天0.5微克，但在8周后降至每天0.25微克。婴儿在哺乳期间茁壮成长，在1周、3周和3个月大时血清钙水平正常。
一名妇女在服用钙三醇，剂量为每天0.75和1微克的情况下，在两次怀孕后对婴儿进行了哺乳。没有不良反应的报告。
一名妇女在服用钙三醇，剂量为每天三次，每次0.5微克的情况下，对新生儿进行了9天的哺乳。由于高钙血症，钙三醇在那时停止使用，但在产后40天重新开始使用低剂量，逐渐增加，直到在哺乳结束前12.5个月达到产前剂量1.5微克/天。
一名患有盘状红斑狼疮的妇女每隔两天服用钙三醇0.25微克，并同期服用其他几种药物。她的婴儿被哺乳了12个月，并在15个月大时进行了随访。在哺乳期间没有报告不良反应，婴儿在15个月大时生长和发育正常。
一名患有常染色体显性低甲状旁腺病1型的哺乳母亲在产后8个月接受特立帕肽治疗，然后改为每天两次服用钙三醇0.5微克。她为婴儿进行了6个月的纯母乳喂养，然后补充到1年。当开始服用母体钙三醇时，她的婴儿血清钙没有变化。母亲在11个月大时开始断奶，1岁时断奶完成。1.5岁时生长和发育正常。
对哺乳和母乳的影响：截至修订日期，未找到相关已发布信息。
◉ Summary of Use during Lactation:Calcitriol is the normal physiologically active form of vitamin D, 1,25-dihydroxyvitamin D. Several women with hyocalcemia have successfully breastfed during breastfeeding, with sometimes fluctuating serum calcium levels. Limited data indicate that its use in nursing mothers in appropriately adjusted doses does not affect the breastfed infant. If calcitriol is required by the mother, it is not a reason to discontinue breastfeeding. Calcitriol and calcium dosage requirements are usually reduced during lactation in women with hypoparathyroidism.
◉ Effects in Breastfed Infants:A woman with hypoparathyroidism breastfed her infant from week 1 to week 32 postpartum while taking calcitriol. The dose was initially 0.5 mcg daily, but was decreased to 0.25 mcg daily after 8 weeks. The infant thrived during breastfeeding and had normal serum calcium levels at 1 and 3 weeks and 3 months of age.
A woman breastfed infants after two pregnancies while taking calcitriol in doses of 0.75 and 1 mcg daily. There were no reports of adverse reactions.
A woman breastfed her newborn infant for 9 days while taking calcitriol 0.5 mcg three times daily. Calcitriol was stopped at that time because of hypercalcemia, but restarted at 40 days postpartum in low doses that were gradually increased until the prepregnancy dosage of 1.5 mcg daily was reached just before weaning at 12.5 months postpartum.
A woman with discoid lupus was taking calcitriol 0.25 mcg every 2 days and several other medications concurrently. Her infant was breastfed for 12 months and followed up at 15 months of age. No adverse effects were reported during breastfeeding and the infant was growing and developing normally at 15 months of age.
A nursing mother with autosomal dominant hypoparathyroidism type 1 was treated with teriparatide for 8 months postpartum then calcitriol 0.5 mcg twice daily was substituted. She breastfed her infant exclusively for 6 months then with supplementation to 1 year. Her infant had no change in serum calcium when maternal calcitriol was begun. The mother began weaning at 11 months and at 1 year of age weaning was complete. Growth and development were normal at 1.5 years of age.
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
来源:Drugs and Lactation Database (LactMed)
