毒理性
◉ 母乳喂养期间使用概要:在一项研究中,一名在哺乳期间服用波生坦的患者的乳汁中发现了非常低的药物水平。另一名妇女在服用西地那非的同时哺乳她的早产新生儿,没有报告不良反应。在获得更多数据之前,波生坦在哺乳期间应仅在有仔细监测婴儿的情况下使用。
◉ 对哺乳婴儿的影响:一名23岁的先天性心脏病和肺动脉高压妇女在怀孕期间以未指明的剂量接受了波生坦和西地那非治疗。产后这些药物和华法林继续使用。她的婴儿在30周通过剖宫产分娩,出生时体重为1.41公斤。根据作者的说法,她在新生儿重症监护室哺乳了11周,“结果良好”,但婴儿在26周时因呼吸道合胞病毒感染而死亡。
一名正在哺乳她21个月大婴儿的妇女,每天三次服用20毫克的西地那非,每天两次服用125毫克的波生坦,以治疗肺动脉高压。这些药物是在产后6个月以上开始的。母亲没有报告从婴儿出生到产后651天部分哺乳期间可能的任何不良反应、严重健康问题或婴儿住院。
◉ 对泌乳和乳汁的影响:截至修订日期,没有找到相关的已发布信息。
◉ Summary of Use during Lactation:A study in one patient taking bosentan during breastfeeding found very low levels in milk. Another woman breastfed her preterm newborn while taking sildenafil with no adverse effects reported. Until more data are available, bosentan should only be used with careful infant monitoring during breastfeeding.
◉ Effects in Breastfed Infants:A 23-year-old woman with congenital heart disease and pulmonary hypertension was treated during pregnancy with bosentan and sildenafil in unspecified dosages. These drugs and warfarin were continued postpartum. Her infant was delivered at 30 weeks by cesarean section and weighed 1.41 kg at birth. She nursed the infant in the neonatal intensive care unit for 11 weeks "with good outcome" according to the authors, but the infant died at 26 weeks from a respiratory syncytial virus infection.
A woman breastfeeding her 21-month-old infant was taking 20 mg of sildenafil 3 times daily and 125 mg of bosentan twice daily to treat pulmonary arterial hypertension. The drugs were begun more than 6 months after 6 months postpartum. The mother did not report any possible adverse effects, serious health problem or hospitalization of the infant in the period from birth until day 651 postpartum when the infant continued to be partially breastfed.
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
来源:Drugs and Lactation Database (LactMed)