毒理性
◉ 母乳喂养期间使用总结:一个专家小组认为在哺乳期间使用氨茶碱是可以接受的。[1] 母亲使用氨茶碱偶尔可能会导致婴儿兴奋、烦躁和睡眠不安。新生儿尤其是早产儿最有可能受到影响,因为他们的茶碱消除速度慢且血清蛋白结合率低。没有必要避免使用氨茶碱产品;然而,应保持母体血清茶碱浓度在治疗范围的下限,并监测婴儿是否有茶碱副作用的迹象。婴儿血清茶碱浓度可以帮助确定兴奋迹象是否由茶碱引起。在静脉注射后2小时或口服即释型氨茶碱产品后4小时避免哺乳可以减少哺乳婴儿接受的剂量。
◉ 对哺乳婴儿的影响:在一项研究中,一名3天大的哺乳婴儿在母亲每6小时摄入200毫克氨茶碱的日子里出现了烦躁和睡眠不安。这些效果在停止使用后消失,并在接下来的9个月重新使用时再次出现。这些效果可能是由母乳中的茶碱引起的。这篇论文中报告的另外五名婴儿在母亲摄入茶碱后没有出现不良反应。[3] 由于新生儿和早产儿消除茶碱的速度较慢,他们血清中茶碱的积累最有可能是发生的。[2][5]
◉ 对泌乳和母乳的影响:截至修订日期,没有找到相关的已发布信息。
◉ Summary of Use during Lactation:An expert panel considers use of aminophylline to be acceptable during breastfeeding.[1] Maternal aminophylline use may occasionally cause stimulation and irritability and fretful sleep in infants. Newborn and especially preterm infants are most likely to be affected because of their slow elimination and low serum protein binding of theophylline. There is no need to avoid aminophylline products; however, keep maternal serum theophylline concentrations in the lower part of the therapeutic range and monitor the infant for signs of theophylline side effects. Infant serum theophylline concentrations can help to determine if signs of agitation are due to theophylline. Avoiding breastfeeding for 2 hours after intravenous or 4 hours after an immediate-release oral aminophylline product can decrease the dose received by the breastfed infant.
◉ Effects in Breastfed Infants:Irritability and fretful sleeping occurred in a 3-day-old breastfed infant on days of maternal aminophylline intake of 200 mg every six hours. These effects ceased with discontinuation and recurred on rechallenge over the next 9 months. These effects were probably caused by theophylline in breastmilk. Another five infants reported in this paper showed no adverse reactions after maternal theophylline ingestion.[3] Accumulation of theophylline in infant serum appears most likely in neonates and premature infants because they eliminate theophylline slowly.[2][5]
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
来源:Drugs and Lactation Database (LactMed)