毒理性
◉ 母乳喂养期间使用总结:偶尔小剂量的曲普利定不会预期对哺乳婴儿产生任何不良影响。较大剂量或更长时间的使用可能会对婴儿产生影响或减少乳汁供应,尤其是与伪麻黄碱等拟交感神经药联合使用或在母乳喂养尚未建立时。首选非镇静抗组胺药作为替代品。
◉ 对哺乳婴儿的影响:在一项电话随访研究中,母亲报告有10%的婴儿接触到各种抗组胺药后出现烦躁和肠绞痛症状,1.6%的婴儿出现嗜睡。没有一种反应需要医疗关注,也没有母亲服用曲普利定。
在一项研究中,三名母亲服用了一剂曲普利定2.5毫克和伪麻黄碱60毫克后,没有报告婴儿出现副作用。
◉ 对泌乳和母乳的影响:与非哺乳期妇女和产后早期妇女相比,注射相对高剂量的抗组胺药可以降低基础血清催乳素。然而,抗组胺药预处理产后母亲并不影响吸吮诱导的催乳素分泌。尚未研究较低口服剂量的抗组胺药是否对血清催乳素有相同的影响,或者催乳素的影响是否对母乳喂养成功有任何影响。在已建立泌乳的母亲中,催乳素水平可能不会影响她的哺乳能力。
◉ Summary of Use during Lactation:Small, occasional doses of triprolidine would not be expected to cause any adverse effects in breastfed infants. Larger doses or more prolonged use may cause 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 nonsedating antihistamines are preferred alternatives.
◉ 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 and none of the mothers were taking triprolidine.
In one study, no infant side effects were reported in three infants whose mothers took one dose of triprolidine 2.5 mg and pseudoephedrine 60 mg.
◉ Effects on Lactation and Breastmilk:Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women. However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers. Whether lower oral doses of antihistamines 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.
来源:Drugs and Lactation Database (LactMed)