毒理性
哺乳期使用概述:奥丹泽琼(Ondansetron)常用于剖宫产期间和之后的恶心治疗,通常通过静脉注射4至8毫克。在剖宫产期间和之后使用奥丹泽琼似乎不会影响哺乳的开始。在这种设置中或在接受奥丹泽琼产后药代动力学研究的女性中,没有报告对婴儿有不良影响。对于哺乳期母亲在产后即时设置之外使用奥丹泽琼的研究不够充分,但该药物被标记为适用于1个月大的婴儿。计算机模型显示,乳汁中的量远低于这一剂量。无需特殊预防措施。
对哺乳婴儿的影响:在一项对78位接受奥丹泽琼静脉注射产后女性的药代动力学研究中,没有报告她们的哺乳婴儿出现不良影响。
对哺乳和乳汁的影响:一项随机双盲研究比较了剖宫产后作为预防术后恶心和呕吐的安慰剂与静脉注射奥丹泽琼4毫克的效果。两组之间第一次哺乳的时间没有差异。
在一项回顾性研究中,比较了接受剖宫产的三组妇女:麻醉前和分娩期间使用右美托咪定(n = 115),麻醉前和分娩期间使用生理盐水,分娩后使用右美托咪定(n = 109),麻醉前和分娩期间使用生理盐水(n = 168)。所有妇女根据需要和拆线前接受4毫克奥丹泽琼。妇女在各个组别中消耗的奥丹泽琼平均总量从6毫克到9毫克不等。各组第一次产生乳汁的时间相似(25至28分钟)。
◉ Summary of Use during Lactation:Ondansetron is frequently used for nausea during and after cesarean section, usually in doses of 4 to 8 mg intravenously. Use during and after cesarean section appears to not affect the onset of breastfeeding. No adverse infant effects have been reported in this setting or among women who received ondansetron postpartum in a pharmacokinetic study. Use of ondansetron in nursing mothers beyond the immediate postpartum setting has not been studied well, but the drug is labeled for use in infants as young as 1 month of age. A computer model demonstrated that the amounts in milk are much less than this dose. No special precautions are required.
◉ Effects in Breastfed Infants:In a pharmacokinetic study of 78 women who received ondansetron intravenously postpartum, no adverse effects were reported in their breastfed infants.
◉ Effects on Lactation and Breastmilk:A randomized, double-blind study compared placebo to intravenous ondansetron 4 mg given after cesarean section as prophylaxis for postoperative nausea and vomiting. There was no difference in the time of the first breastfeeding between the two groups.
In a retrospective study of women undergoing cesarean section deliveries, 3 regimens were compared: dexmedetomidine before anesthesia and during delivery (n = 115), normal saline before anesthesia and during delivery and dexmedetomidine after delivery (n = 109), and normal saline before anesthesia and during delivery (n = 168). All women received ondansetron 4 mg as needed and before removal of sutures. The average total amount of ondansetron consumed in the women ranged from 6 mg to 9 mg in the various groups. The time to first production of milk was similar in all groups (25 to 28 minutes).
来源:Drugs and Lactation Database (LactMed)