Farmacoriflessioni
Valutazione dei farmaci in corso di allattamento al seno: i corticosteroidi
DRUG SAFETY DURING BREASTFEEDING: CORTICOSTEROIDS
RICCARDO DAVANZO1, IPPOLITA RONCORONI2, LAURA RUBERT3, CHIARA ORETTI3
1UO di Neonatologia e TIN, IRCCS “Burlo Garofolo”, Trieste;
2Pediatra di famiglia (Pavia);
3Scuola di Specializzazione in Pediatria dell’Università di Trieste
Ottobre 2007 - pagg. 527 -530
Abstract
The safety profile of drugs for the nursing infant and for the breastfeeding mother is a common issue for the pediatrician. Advice from current literature is not exhaustive, it varies according to different sources of information and sometimes is contradictory. The case of the use of corticosteroids during breastfeeding is presented as an example of such a meta-variability. According to the review of the most authoritative sources in scientific literature, the use of corticosteroid in short courses, as well as in long ones, is safe for the nursing infant.
Parole chiave
Classificazione MeSH
Bibliografia
1. American Academy of Pediatrics. Committee
on Drugs, The transfer of drugs and other
chemicals into human milk. Pediatrics 2001;
108:776-89.
2. Briggs et al. Drugs in Pregnancy and Lactation. 7th Ed. Lippincott, Williams and Wilkins, 2005.
3. AIFA: Agenzia Italiana del Farmaco. Guida all’uso dei farmaci, sulla base del British National Formulary 2005.
4. Hale W. Medications and mother’s milk. 13a edizione, 2006.
5. Hardman JG, Limbird LE. Goodman & Gilman’s The pharmacological basis of therapeutics. Tenth Edition. New York: McGraw- Hill, 2001.
6. Anderson PO. Corticosteroids use by breast- feeding mothers. Clin Pharm 1987;6:445.
7. Berlin CM, Kaiser DG, Demers L. Excretion of prednisone in human milk. Pharmacologist 1979;21:264.
8. Greenberger PA, Odeh YK, Frederiksen MC, Atkinson AJ jr. Pharmacokinetics of prednisolone transfer to breastmilk. Clin Pharmacol Ther 1993;53:324-8.
9. Ostensen M, Khamashta M, Lockshin M, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther 2006;8(3):209.
10. Shinwell ES, Karplus M, Reich D, et al. Early postnatal dexamethasone treatment and increased incidence of cerebral palsy. Arch Dis Child Fetal Neonatal 2000;83:F177-81.
11. Kutschera J, Tomaselli J, Maurer U, Mueller W, Urlesberger B. Minor neurological dysfunction, cognitive development and somatic development at the age of 3 to 7 years after dexamethasone treatment in very-low birthweight infants. Early Human Development 2005;81:281-7.
12. Stark AR, Carlo WA, Tyson JE, et al. Adverse effects of early dexametasone treatment in extremely low birth weight infants. N Engl J Med 2001;344:95-101.
13. Hale TW, Berens PD. Clinical Therapy in Breastfeeding patients. 2nd Ediztion. Pharmasoft Medical Publishing, Amarillo, TX, 2002.
14. Derendorf H, Mollmann H, Barth J, Mollmann C, Tunn S, Krieg M. Pharmacokinetics and oral bioavaibility of hidrocortisone. J Clin Pharmacol 1991;31(5):473-6.
15. Confavreux C, Hutchinson M, Hours MM, Cortinovis-Tourniaire P, Moreau T. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. N Engl J Med 1998:339(5):285-91.
16. Vukusic S. Confavreux C. Pregancy and multiple sclerosis: the children of PRIMS. Clin Neurol Neurosurg 2006;108:266-70. Epub 2006 Jan 4.
17. Gulick EE, Johnson S. Infant health of mothers with multiple sclerosis. West J Nurs Res 2004;26(6):632-49.
18. Lawrence RA, Lawrence RM. Rheumatoid arthritis and other connective tissue disorders. In: Breastfeeding. A guide for the medical profession. 6th Edition. Elsevier Mosby, 2005.
19. Karlson EW, Mandl LA, Hankinson SE, Grodstein F. Do breast-feeding and other reproductive factors influence future risk of rheumatoid arthritis? Results from the Nurses’Health Study. Arthritis Rheum 2004;50 (11):3458-67.
20. Barrett JH, Brennan P, Fiddler M, Silman A. Breast-feeding and postpartum relapse in women with rheumatoid and inflammatory arthritis. J Gend Specif Med 2002;5(4):28-37.
2. Briggs et al. Drugs in Pregnancy and Lactation. 7th Ed. Lippincott, Williams and Wilkins, 2005.
3. AIFA: Agenzia Italiana del Farmaco. Guida all’uso dei farmaci, sulla base del British National Formulary 2005.
4. Hale W. Medications and mother’s milk. 13a edizione, 2006.
5. Hardman JG, Limbird LE. Goodman & Gilman’s The pharmacological basis of therapeutics. Tenth Edition. New York: McGraw- Hill, 2001.
6. Anderson PO. Corticosteroids use by breast- feeding mothers. Clin Pharm 1987;6:445.
7. Berlin CM, Kaiser DG, Demers L. Excretion of prednisone in human milk. Pharmacologist 1979;21:264.
8. Greenberger PA, Odeh YK, Frederiksen MC, Atkinson AJ jr. Pharmacokinetics of prednisolone transfer to breastmilk. Clin Pharmacol Ther 1993;53:324-8.
9. Ostensen M, Khamashta M, Lockshin M, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther 2006;8(3):209.
10. Shinwell ES, Karplus M, Reich D, et al. Early postnatal dexamethasone treatment and increased incidence of cerebral palsy. Arch Dis Child Fetal Neonatal 2000;83:F177-81.
11. Kutschera J, Tomaselli J, Maurer U, Mueller W, Urlesberger B. Minor neurological dysfunction, cognitive development and somatic development at the age of 3 to 7 years after dexamethasone treatment in very-low birthweight infants. Early Human Development 2005;81:281-7.
12. Stark AR, Carlo WA, Tyson JE, et al. Adverse effects of early dexametasone treatment in extremely low birth weight infants. N Engl J Med 2001;344:95-101.
13. Hale TW, Berens PD. Clinical Therapy in Breastfeeding patients. 2nd Ediztion. Pharmasoft Medical Publishing, Amarillo, TX, 2002.
14. Derendorf H, Mollmann H, Barth J, Mollmann C, Tunn S, Krieg M. Pharmacokinetics and oral bioavaibility of hidrocortisone. J Clin Pharmacol 1991;31(5):473-6.
15. Confavreux C, Hutchinson M, Hours MM, Cortinovis-Tourniaire P, Moreau T. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. N Engl J Med 1998:339(5):285-91.
16. Vukusic S. Confavreux C. Pregancy and multiple sclerosis: the children of PRIMS. Clin Neurol Neurosurg 2006;108:266-70. Epub 2006 Jan 4.
17. Gulick EE, Johnson S. Infant health of mothers with multiple sclerosis. West J Nurs Res 2004;26(6):632-49.
18. Lawrence RA, Lawrence RM. Rheumatoid arthritis and other connective tissue disorders. In: Breastfeeding. A guide for the medical profession. 6th Edition. Elsevier Mosby, 2005.
19. Karlson EW, Mandl LA, Hankinson SE, Grodstein F. Do breast-feeding and other reproductive factors influence future risk of rheumatoid arthritis? Results from the Nurses’Health Study. Arthritis Rheum 2004;50 (11):3458-67.
20. Barrett JH, Brennan P, Fiddler M, Silman A. Breast-feeding and postpartum relapse in women with rheumatoid and inflammatory arthritis. J Gend Specif Med 2002;5(4):28-37.
Corrispondenza: davanzor@burlo.trieste.it