毒理性
◉ 母乳喂养期间使用概述：地索奈德在母乳喂养期间尚未进行研究。由于只有大量使用最强效的皮质类固醇才可能在母亲体内产生系统性影响，因此短期使用局部皮质类固醇不太可能通过进入母乳而对哺乳婴儿构成风险。然而，尽量使用最弱效的药物，并尽可能在最小的皮肤区域使用是谨慎的做法。特别是要确保婴儿的皮肤不直接接触到已经涂抹药物的皮肤区域。应仅在水溶性的乳膏或凝胶产品上使用，因为药膏可能会通过舔舐使婴儿接触到高水平的矿物石蜡。地索奈德乳膏或泡沫可在乳头上使用。如果局部皮质类固醇应用于乳房或乳头区域，应在哺乳前彻底擦干净。
◉ 对哺乳婴儿的影响：将一种具有相对较高盐皮质激素活性的皮质类固醇（异氟泼尼松醋酸酯）局部应用于母亲的乳头，导致她的2个月大哺乳婴儿出现QT间期延长、库欣综合症外貌、严重高血压、生长减少和电解质异常。这位母亲从出生时起就因为乳头疼痛而使用该乳膏。
◉ 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:Desonide has not been studied during breastfeeding. Since only extensive application of the most potent corticosteroids may cause systemic effects in the mother, it is unlikely that short-term application of topical corticosteroids would pose a risk to the breastfed infant by passage into breastmilk. However, it would be prudent to use the least potent drug on the smallest area of skin possible. It is particularly important to ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking. Desonide cream or foam are acceptable to use on the nipple. Any topical corticosteroid should be wiped off thoroughly prior to nursing if it is being applied to the breast or nipple area.
◉ Effects in Breastfed Infants:Topical application of a corticosteroid with relatively high mineralocorticoid activity (isofluprednone acetate) to the mother's nipples resulted in prolonged QT interval, cushingoid appearance, severe hypertension, decreased growth and electrolyte abnormalities in her 2-month-old breastfed infant. The mother had used the cream since birth for painful nipples.
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
来源:Drugs and Lactation Database (LactMed)
