毒理性
◉ 母乳喂养期间使用概述:有限的信息表明,cefpodoxime在乳汁中含量较低,预计不会对哺乳婴儿造成任何不良影响。偶尔有报道称,头孢菌素类药物可能会破坏婴儿的胃肠道菌群,导致腹泻或鹅口疮,但这些影响尚未得到充分评估。Cefpodoxime在哺乳期母亲中是可以接受的。
◉ 对哺乳婴儿的影响:截至修订日期,未找到相关的已发布信息。
◉ 对泌乳和母乳的影响:一位非孕妇,40岁的女性,在服用cefpodoxime 200毫克,每日两次,共2天后出现了高催乳素血症和双侧乳汁分泌。停药7天后,乳汁分泌停止,血清催乳素显著下降至正常范围。一个月后,它进一步下降。由于没有找到其他原因,作者确定乳汁分泌和高催乳素血症很可能是由于cefpodoxime引起的。
一位22岁的女性,在服用缓释文拉法辛150毫克,每日一次,共3个月后,报告在服用cefpodoxime 200毫克,每日两次,共14天(大约在2周前开的处方)后,出现了双侧乳房充血和乳汁分泌,持续3天。实验室检查和头部CT结果除碱性磷酸酶略有升高和血清催乳素水平升高外,均正常。她的乳汁分泌在2周内开始减少,并在3周内消失,文拉法辛剂量未变。她的血清催乳素水平也恢复正常。作者认为她的症状和高催乳素血症很可能是由于cefpodoxime引起的。
对于已经建立泌乳的母亲,催乳素水平可能不会影响她的哺乳能力。
◉ Summary of Use during Lactation:Limited information indicates that cefpodoxime produces low levels in milk and is not be expected to cause any adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. Cefpodoxime is acceptable in nursing mothers.
◉ Effects in Breastfed Infants:Relevant published information was not found as of the revision date.
◉ Effects on Lactation and Breastmilk:Hyperprolactinemia and bilateral galactorrhea occurred in a nonpregnant, 40-year-old woman taking cefpodoxime 200 mg twice daily for 2 days. Seven days after stopping the drug, galactorrhea ceased and the serum prolactin dropped markedly into the normal range. One month later it had dropped further. Because no other cause could be found, the authors determined that the galactorrhea and hyperprolactinemia were probably caused by cefpodoxime.
A 22-year-old woman who had been taking slow-release venlafaxine 150 mg daily for 3 months reported bilateral breast engorgement and galactorrhea for 3 days after being prescribed cefpodoxime 200 mg twice daily for 14 days 2 weeks prior. Laboratory and head CT results were normal except for a slight elevation in alkaline phosphatase and an elevated serum prolactin level. Her galactorrhea began decreasing within 2 weeks and disappeared in 3 weeks with no change in venlafaxine dosage. Her serum prolactin level also returned to normal. The authors felt that her symptoms and hyperprolactinemia were probably caused by cefpodoxime.
The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
来源:Drugs and Lactation Database (LactMed)