毒理性
使用母乳期间总结:由于母乳中卡托普利的含量较低,婴儿摄入的量很小,预计不会对哺乳婴儿产生任何不良影响。
对哺乳婴儿的影响:在一项12位母亲的报告中,几位母亲在每天三次每次服用卡托普利100毫克的同时继续哺乳。婴儿中没有看到不良影响。[1]
一位妇女在怀孕期间被诊断为库欣病。产后,她每天三次服用美替拉酮250毫克,每天两次服用比索洛尔10毫克,以及每天两次服用卡托普利12.5毫克。她以大约50%的牛奶和50%的配方奶喂养她的早产儿。在产后5周时,婴儿的儿科团队发现他的生长和发展是适当的。[3]
对泌乳和母乳的影响:在一篇报告中的一系列对照研究中,卡托普利对催乳素分泌肿瘤患者的催乳素昼夜节律、对催乳素刺激药物的响应或血清催乳素没有影响。[4]
在一项对年轻高血压男性的研究中,口服卡托普利25毫克在服用后90分钟显著降低了血清催乳素水平,与安慰剂相比。[5] 对于已经建立泌乳的母亲,母体催乳素水平可能不会影响她的哺乳能力。
在一项报告中,12名受试者中有1名妇女在每天三次每次服用卡托普利100毫克时无法产生足够的乳汁进行研究所需,尽管她之前已经成功哺乳了6个月。[1] 目前尚不清楚这种减少是否是卡托普利的影响。
◉ Summary of Use during Lactation:Because of the low levels of captopril in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.
◉ Effects in Breastfed Infants:In one report of 12 mothers, several continued to breastfeed their infants while taking captopril 100 mg three times daily. No adverse effects were seen in the infants.[1]
A woman was diagnosed with Cushing's disease during pregnancy. Postpartum she took metyrapone 250 mg 3 times daily, bisoprolol 10 mg twice daily, and captopril 12.5 mg twice daily. She breastfed her preterm infant about 50% milk and 50% formula. At 5 weeks postpartum, the infant's pediatric team found his growth and development to be appropriate.[3]
◉ Effects on Lactation and Breastmilk:In a series of controlled studies reported in one paper, captopril had no effect on the circadian rhythm of prolactin, the response to prolactin-stimulating drugs or serum prolactin in patients with prolactin-secreting tumors.[4]
In a study of young hypertensive males, captopril 25 mg orally markedly decreased serum prolactin at 90 minutes after the dose compared to placebo.[5] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.
In one report, 1 woman out of 12 subjects was unable to produce enough milk for the study while taking captopril 100 mg 3 times daily even though she had been successfully breastfeeding for 6 months.[1] It is not known if this decrease was an effect of captopril.
来源:Drugs and Lactation Database (LactMed)