毒理性
◉ 母乳喂养期间使用总结:由于母乳中普萘洛尔的含量较低,婴儿摄入的量很小,预计不会对哺乳婴儿产生任何不良反应。在母乳喂养期间的研究没有发现明确归因于普萘洛尔的不良反应。无需特殊预防措施。普萘洛尔在母乳喂养期间持续性乳房疼痛的病例中已成功使用。
◉ 对哺乳婴儿的影响:一项对哺乳期间服用β受体阻滞剂的母亲进行的研究发现,服用任何β受体阻滞剂的母亲的婴儿中有不良反应的数目在数值上有所增加,但无统计学意义。尽管对照婴儿的年龄进行了匹配,但受影响婴儿的年龄并未说明。在8位服用普萘洛尔的母亲中,有一位报告其哺乳婴儿出现嗜睡,但她同时也在服用其他未指明的用于治疗高血压的药物。
法国药物警戒系统报告了一例2天大的哺乳婴儿出现心动过缓的案例。然而,报告中并未明确说明母亲在接近分娩期时是否服用了普萘洛尔,并可能通过胎盘将药物传给了婴儿。
◉ 对泌乳和母乳的影响:截至修订日期,没有找到关于正常哺乳期间β受体阻滞或普萘洛尔影响的相关已发布信息。一项对6名高催乳素血症和乳汁过多的患者进行的研究发现,在使用普萘洛尔进行β肾上腺素能阻断后,血清催乳素水平没有变化。
◉ Summary of Use during Lactation:Because of the low levels of propranolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. Studies during breastfeeding have found no adverse reactions in breastfed infants clearly attributable to propranolol. No special precautions are required. Propranolol has been used successfully in cases of persistent pain of the breast during breastfeeding.
◉ Effects in Breastfed Infants:A study of mothers taking beta-blockers during nursing found a numerically, but not statistically significant increased number of adverse reactions in those taking any beta-blocker. Although the ages of infants were matched to control infants, the ages of the affected infants were not stated. Of 8 mothers taking propranolol, one reported sleepiness in her breastfed infant, but she was also taking other unspecified drugs for hypertension.
A case of bradycardia in a 2-day-old breastfed infant was reported to the French pharmacovigilance system. However it is not clear from the report whether the mother had been taking propranolol near term and might have transmitted the drug to the infant transplacentally.
◉ Effects on Lactation and Breastmilk:Relevant published information on the effects of beta-blockade or propranolol during normal lactation was not found as of the revision date. A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol.
来源:Drugs and Lactation Database (LactMed)