毒理性
◉ 母乳喂养期间使用总结:非常少量的氯喹会分泌到母乳中;当每周一次给药时,药量不足以对婴儿造成伤害,也不足以通过母乳保护孩子免受疟疾的侵害。英国疟疾治疗指南建议,在母乳喂养期间每周给予500毫克氯喹,直到哺乳结束,并且可以给予伯氨喹。母乳喂养的婴儿应接受推荐的氯喹剂量作为疟疾预防。在HIV感染的女性中,经过氯喹治疗后,乳汁中升高的HIV病毒载量降低的程度比其他使用磺胺多辛和乙胺嘧啶联合治疗的女性更大。由于在母乳喂养期间每天使用氯喹的信息不可用,在这种情况下,可能更倾向于使用羟氯喹或其他药物,特别是在哺乳新生儿或早产儿时。
◉ 对哺乳婴儿的影响:几位作者指出,在流行地区,使用氯喹进行哺乳母亲的疟疾预防是常见的。截至修订日期,尚未发布有关哺乳婴儿出现不良反应的报告。
◉ 对泌乳和母乳的影响:截至修订日期,未找到相关的已发布信息。
◉ Summary of Use during Lactation:Very small amounts of chloroquine are excreted in breast milk; when given once weekly, the amount of drug is not sufficient to harm the infant nor is the quantity sufficient to protect the child from malaria. United Kingdom malaria treatment guidelines recommend that weekly chloroquine 500 mg be given until breastfeeding is completed and primaquine can be given. Breastfeeding infants should receive the recommended dosages of chloroquine for malaria prophylaxis. In HIV-infected women, elevated viral HIV loads in milk were decreased after treatment with chloroquine to a greater extent than other women who were treated with the combination of sulfadoxine and pyrimethamine. Because no information is available on the daily use of chloroquine during breastfeeding, hydroxychloroquine or another agent may be preferred in this situation, especially while nursing a newborn or preterm infant.
◉ Effects in Breastfed Infants:Several authors have pointed out that malaria prophylaxis in nursing mothers with chloroquine is common in endemic areas. As of the revision date, no reports of adverse reactions in breastfed infants have been published.
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
来源:Drugs and Lactation Database (LactMed)