毒理性
哺乳期使用总结:由于在哺乳期间使用比索洛尔的经验较少,可能更倾向于使用其他药物,特别是在哺乳新生儿或早产儿时。
对哺乳婴儿的影响:一项研究调查了哺乳期间服用β受体阻滞剂的母亲,发现服用任何β受体阻滞剂的母亲其婴儿出现不良反应的数量在数值上有所增加,但无统计学意义。尽管对照婴儿的年龄进行了匹配,但受影响婴儿的年龄并未说明。然而,这些母亲中没有人在服用比索洛尔。[3] 与比索洛尔具有相似通过乳汁排泄特性的β肾上腺素受体阻滞剂在哺乳的新生儿中引起了不良反应。[4][5]
一名妇女在怀孕期间被诊断为库欣病。产后,她每天三次服用美替拉酮250毫克,每天两次服用比索洛尔10毫克,以及每天两次服用卡托普利12.5毫克。她以大约50%的牛奶和50%的配方奶喂养她的早产儿。在产后5周,婴儿的儿科团队发现他的生长和发展是适当的。[4]
对泌乳和乳汁的影响:一项针对6名高催乳素血症和乳汁分泌过多的患者的研究发现,在使用普萘洛尔进行β肾上腺素受体阻断后,血清催乳素水平没有变化。[5]截至修订日期,尚未找到关于在正常哺乳期间β受体阻滞或比索洛尔影响的已发布相关信息。
◉ Summary of Use during Lactation:Because there is little published experience with bisoprolol during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
◉ Effects in Breastfed Infants:A study of mothers taking beta-blockers during nursing found a numerically, but not statistically significant increased number of adverse reactions in those taking any beta-blocker. Although the ages of infants were matched to control infants, the ages of the affected infants were not stated. However, none of the mothers were taking bisoprolol.[3] Beta-adrenergic blocking drugs with breastmilk excretion characteristics similar to bisoprolol have caused adverse effects in breastfed newborns.[4][5]
A woman was diagnosed with Cushing's disease during pregnancy. Postpartum she took metyrapone 250 mg 3 times daily, bisoprolol 10 mg twice daily, and captopril 12.5 mg twice daily. She breastfed her preterm infant about 50% milk and 50% formula. At 5 weeks postpartum, the infant's pediatric team found his growth and development to be appropriate.[4]
◉ Effects on Lactation and Breastmilk:A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol.[5] Relevant published information on the effects of beta-blockade or bisoprolol during normal lactation was not found as of the revision date.
来源:Drugs and Lactation Database (LactMed)