毒理性
◉ 母乳喂养期间使用概要:目前没有关于母乳喂养期间使用卡替洛尔的数据。由于卡替洛尔可能广泛排入母乳中,因此在喂养新生儿时,优先选择其他β-肾上腺素能阻滞剂而不是口服卡替洛尔。两个月以上的婴儿肾功能更成熟,不太可能受到影响。
母亲使用卡替洛尔眼药对哺乳婴儿的风险应该很小,尽管一些指南指出,凝胶制剂比溶液更受推荐。在使用眼药水后,通过按压眼角处的泪管1分钟或更长时间,然后使用吸收性纸巾去除多余的溶液,可以显著减少进入母乳的药物量。
◉ 对哺乳婴儿的影响:一项研究调查了哺乳期间服用β-阻滞剂的母亲,发现服用任何β-阻滞剂的母亲其不良反应数量在数值上有所增加,但无统计学意义。尽管对照婴儿的年龄与受影响的婴儿年龄相匹配,但受影响婴儿的具体年龄并未说明。没有母亲服用卡替洛尔。具有类似母乳排泄特性的β-肾上腺素能阻滞剂在哺乳新生儿中引起了不良反应。
◉ 对泌乳和母乳的影响:一项对6名高催乳素血症和乳汁过多患者的研究发现,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。目前尚无关于β-阻断剂或卡替洛尔在正常哺乳期间使用的影响的报告。
◉ Summary of Use during Lactation:No data are available for the use of carteolol during breastfeeding. Because its excretion into breastmilk is probably extensive, other beta-adrenergic blocking drugs are preferred to oral carteolol while breastfeeding a neonate. Infants over 2 months of age have more mature kidney function and are less likely to be affected.
Ophthalmic use of carteolol by the mother should pose little risk to the breastfed infant, although some guidelines state that gel formulations are preferred over solutions. substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
◉ 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. None of the mothers were taking carteolol. Beta-adrenergic blocking drugs with similar breastmilk excretion characteristics have caused adverse effects in breastfed newborns.
◉ Effects on Lactation and Breastmilk:A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol. There are no reports on the effects of beta-blockade or carteolol use during normal lactation.
来源:Drugs and Lactation Database (LactMed)