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《 授乳(母乳)と喘息の薬 》
マタニティー・ママの幸せな日々を不安なく過ごすためにわたくしたちがサポートいたします。
母乳と喘息の薬に関する知識が出産後必要となります。
《 メッセージ:大部分のの薬は授乳していても大丈夫。お薬は授乳直後に飲みましょう。 》
喘息の薬「授乳(母乳)中でも常用量で安全な喘息の薬」
Safe to Take in Usual Doses
Corticosteroids, Prednisolone(全身性ステロイド)
Erythromycin(エリスロシン)
Inhalers, bronchodilators, and corticosteroids(気管支拡張剤の吸入、ステロイドの吸入)
Theophylline(テオドール、ユニコンetc)
|
コントロールが第一です! |
<資料1>
Drugs and Breast Milk Interactions Chart
(薬物と母乳の相互作用)
※PDR(PHYSICIANS' DESK REFERENCE) 57edition 2003でBrand Nameを検索して一般名を見つけ、次に
治療薬マニュアル2004(医学書院)で日本の商品名を検索した。
The information in the chart below was compiled by Philip Anderson, a pharmacist and the director of the Drug Information Service at the University of California, San Diego Medical Center. If you have more questions about how a drug you are taking may affect your breast milk or your baby, call the UCSD information service at (900) 226-7536, 9 a.m. to 5 p.m. Pacific time, Monday to Friday ($4 for the first minute, $2.50 for every additional minute).
Safe to Take in Usual Doses (常用量でも安全)
Name of Drug |
Brand Name |
Use |
Acetaminophen |
Tylenol(アセトアミノフェン、カロナール) |
Used for pain relief |
Antacids |
Maalox, Mylanta |
Used to treat upset stomachs |
Bupivacaine |
Marcaine |
A local anesthetic |
Caffeine |
coffee, cola drinks |
A stimulant |
Cephalosporins(抗生剤セファロスポリン系) |
Keflex(ケフレックス), Ceclor(ケフラール), Ceftin(オラセフ), Omnicef(セフゾン), Suprax(セフスパン) |
An antibiotic used to treat lung, ear, skin, urinary tract, throat and bone infections |
Clotrimazole |
Lotrimin, Mycelex |
Used to treat yeast and fungal infections |
Contraceptives (Progestin-Only) |
Micronor, Norplant, Depo-Provera |
Used for birth control |
Corticosteroids(全身性ステロイド) |
Prednisone
(プレドニン) |
Used to treat inflammation of joints and other conditions |
Decongestant nasal sprays |
Afrin |
Used to treat stuffy noses |
Digoxin |
Lanoxin, ジゴキシン, ジゴシン |
Used to treat heart problems |
Erythromycin
|
E-Mycin, Erythrocin
(エリスロシン) |
Used for skin and respiratory infections |
Fexofenadine |
Allegra(アレグラ) |
Antihistamine for allergies and hay fever |
Fluconazole |
Diflucan(ジフルカン) |
Used to treat yeast infections |
Heparin |
|
An anticoagulant |
Ibuprofen |
Motrin, Advil, ブルフェン |
Used for pain relief |
Inhalers, bronchodilators, and corticosteroids(気管支拡張剤の吸入、ステロイドの吸入) |
Albuterol, Vanceril |
Used for asthma |
Insulin(インシュリン) |
|
For diabetes; dosage required may drop up to 25 percent during lactation |
Labetalol |
Normodyne, Trandate |
Used for high blood pressure |
Laxatives, bulk-forming and stool softening |
Metamucil, Colace |
Used to treat constipation |
Lidocaine |
Xylocaine |
A local anesthetic |
Loratadine |
Claritin(クラリチン) |
Antihistamine for allergies and hay fever |
Low molecular weight heparins (enoxaparin, dalteparin, tinzaparin) |
Lovenox, Fragmin, Innohep |
Anticoagulants |
Magnesium sulfate(硫酸マグネシウム) |
|
Used to treat preeclampsia and eclampsia |
Methyldopa |
Aldomet(アルドメット) |
Used to treat high blood pressure |
Methylergonovine |
Methergine |
Used to prevent or control hemorrhage after childbirth |
Metoprolol |
Lopressor |
A beta-blocker used to treat high blood pressure |
Miconazole(ミコナゾール) |
Monistat 3, フロリード |
Used to treat yeast infections |
Penicillins(抗生剤ペニシリン系) |
Amoxicillin(サワシリン), Penicillin VK |
Used to treat bacterial infections |
Propranolol |
Inderal(インデラル) |
A beta blocker used to treat heart problems, and high blood pressure |
Theophylline(テオフィリン製剤)
|
Theo-Dur
(テオドール、ユニコンetc) |
Used to treat asthma and bronchitis |
Thyroid replacement |
Synthroid |
Used to treat thyroid problems |
Vaccines (all)(ワクチン) |
|
|
Vancomycin(抗生剤バンコマイシン) |
Vancocin, Vancoled |
An antibiotic |
Warfarin |
Coumadin, ワーファリン |
Used to treat or prevent blood clots |
Probably Safe in Usual Doses(おそらく大丈夫=もし影響があったとしても軽度)
Little is known about the effects these drugs may have on a breastfeeding infant, but if there is an effect, it will probably be mild. In rare cases, your child could have an allergic reaction.
Name of Drug |
Brand Name |
Use |
ACE inhibitors(降圧剤ACE阻害薬) |
Enalapril (レニベース), Benazepril (チバセン) |
Used to treat high blood pressure |
Acyclovir and valacyclovir |
Zovirax(ゾビラックス), Valtrex(バルトレックス) |
Antivirals for Herpes infections |
Anticholinergic agents |
Pro-Banthine(プロ・バンサイン) |
Used to treat intestinal and gall bladder spasms; may decrease milk supply |
Anticonvulsants |
Depakote, Dilantin(アレビアチン), carbamazepine(テグレトール) |
avoid ethosuximide(エピレオプチマル、ザロンチン), phenobarbital(フェノバルビタール), and primidone(プリミドン)は駄目! |
Antihistamines |
Benadryl, Chlor-Trimeton(クロール・トリメトン) |
May decrease milk supply and cause infant drowsiness or fussiness |
Antituberculars(抗結核剤) |
INH(ヒドラ) |
Used to treat tuberculosis |
Azathioprine(免疫抑制剤) |
Imuran(アザニン、イムラン) |
Used to suppress the immune system following organ transplants |
Barbiturates (except phenobarbitalフェノバルビタールは駄目!) |
Fiorinal, Fioricet |
For sedation and tension headaches |
Oral Decongestants |
Sudafed, Entex PSE |
Used to treat congestion associated with colds or allergies; may decrease milk supply |
Ergonovine (short course) |
|
Used to treat uterine bleeding. May decrease milk supply. |
Fluconazole(フルコナゾール) |
Diflucan(ジフルカン)
|
Antifungal(抗真菌薬) |
Gadolinium |
Magnevist, Omniscan |
Contrast agent for MRI studies |
Haloperidol(抗精神病薬) |
Haldol(セレネース) |
Used to treat psychosis |
Histamine H2 Blockers
(H2受容体拮抗薬) |
Cimetidine (タガメット), ranitidine (ザンタック), nizatadine (Axid), and famotidine(ガスター) (Pepcid ? preferred) |
Used to treat stomach problems |
Lorazepam(抗不安薬ベンゾジアゼピン系) |
Ativan(ワイパックス) |
Used to treat anxiety |
Methimazole |
Tapazole |
Used to treat hyperthyroidism, < 20 mg/day is probably safe |
Metoclopramide |
Reglan, プリンペラン |
Used for gastrointestinal problems and to increase milk supply |
Naproxen |
Naprosyn, Anaprox, Aleve, ナイキサン |
Used for pain relief; okay if baby is over 1 month old |
Oxazepam |
Serax |
Used to treat anxiety |
Paroxetine(SSRI) |
Paxil(パキシル) |
Used to treat depression |
Phenothiazines(抗精神病薬フェノチアジン誘導体)
|
Compazine (anti-nausea, Stelazine(トリフロペラジン), Thorazine (anti-psychotic, ウインタミン), ノバミン) |
|
Propylthiouracil PTU
(抗甲状腺薬) |
チウラジール、プロパジール |
Used to treat hyperthyroidism |
Quinidine |
|
Used to treat heartbeat irregularities |
Sertraline |
Zoloft |
Used to treat depression |
Spironolactone(利尿剤) |
Aldactone, Aldactazide, アルダクトンA |
Used to treat high blood pressure |
Sulfisoxazole |
Gantrisin |
Used to treat urinary tract infections |
Sumatriptan(片頭痛治療薬) |
Imitrex, イミグラン |
Used to treat migraines |
Tetracyclines < 14 days
(抗生剤テトラサイクリン系) |
tetracycline, doxycycline(ビブラマイシン) |
Used to treat acne and urinary tract infections |
Thiazide diuretics
(利尿剤サイアザイド系) |
HydroDiuril, Esidrix |
Used for high blood pressure and edema |
Tricyclic antidepressants
(三環系抗うつ薬) |
Elavil, Tofranil(トフラニール), Pamelor(ノリトレン) |
Used to treat depression |
Verapamil |
Calan, Isoptin, Verelan, ワソラン |
Used for high blood pressure |
Potentially Hazardous(使用しない or 注意して使用)
You should avoid or use these drugs with caution, particularly while breastfeeding a newborn or premature infant.
Name of Drug |
Brand Name |
Use |
Acebutolol |
Sectral |
A beta blocker used to treat high blood pressure and abnormal heart rhythms. |
Atenolol |
Tenormin |
A beta blocker used to treat high blood pressure and abnormal heart rhythms. |
Antihistamine/decongestant combinations
(抗ヒスタミン剤) |
Contac, Dimetapp |
Used to treat colds and allergies; may decrease your milk supply |
Benzodiazepines
(ベンゾジアゼピン) |
long-acting Librium, Valium, Dalmane |
Used to treat anxiety and for sleep (lorazepam, oxazepam preferred) |
Chlorthalidone |
Hygroton, Thalitone |
Diuretic used to treat high blood pressure; may decrease milk supply |
Citalopram |
Celexa |
Antidepressant; can cause infant drowsiness |
Clindamycin(抗生剤リンコマイシン系) |
Cleocin, ダラシン |
Used to treat abdominal and vaginal infections |
Clonidine |
Catapres(カタプレス) |
Used to treat high blood pressure, may decrease milk supply |
Contraceptives (Estrogen-containing) |
Ortho-Novum, Lo-Ovral, Loestrin |
Used for birth control; may decrease milk supply |
Doxepin |
Sinequan |
Used to treat depression |
Egotamine |
Cafergot(カフェルゴット) |
Used to treat migraines |
Ethosuximide
(エトスクシミド) |
Zarontin
(エピレオプチマル、ザロンチン) |
Used to treat epilepsy |
Fluoxetine |
Prozac, Serafem |
Used to treat depression |
Iodinated contrast media |
|
Used to examine kidneys; withhold breastfeeding temporarily |
Lindane |
Kwell |
Used to treat lice and scabies |
Lithium |
Lithobid(リーマス) |
Used to treat bipolar disease |
Metronidazole(メトロニダゾール) |
Flagyl(フラジール) |
An antibiotic used to treat some intestinal and genital infections
(トリコモナス治療薬) |
Nadolol(ナドロール) |
Corgard
(ナディック) |
A beta blocker used to treat high blood pressure and heart problems |
Narcotics |
Tylenol #3, Vicodin |
Used for pain (one tablet every four hours maximum) |
Nitrofurantoin |
Macrobid |
Used to treat urinary tract infections (safe after the baby is one month old |
Phenobarbital, anticonvulsant doses
(抗てんかん剤としての用量のフェノバルビタール) |
|
Sedative and anticonvulsant |
Piroxicam(ピロキシカム) |
Feldene(パキソ、フェルデン) |
Used to treat arthritis and pain |
Quinolone Antibacterials
(抗生剤キノロン系)
|
Cipro(シプロキサンciprofloxacin)
and Levaquin(クラビットlevofloxacin)
not recommended; Noroxin
(バクシダールnorfloxacin)
is preferred |
Treatment of urinary tract infections and gonorrhea |
Reserpine |
|
Used to treat hypertension |
Sotalol(塩酸ソタロール) |
Betapace(ソタコール) |
Used to treat heart problems |
Thiazide diuretics, long-acting or high doses(利尿剤サイアザイド系) |
Aquatensin, Enduron, Lozol, Renese |
For high blood pressure or edema |
Venlafaxine |
Effexor |
Used to treat depression |
Not safe to take(安全ではない)
You should not use any of these drugs while breastfeeding. If you must take them for health reasons, you should stop breastfeeding ? either temporarily or permanently ? depending on how long you need to take them.
Name of Drug |
Brand Name |
Use |
Amantadine
(アマンタジン) |
Symmetrel(シンメトレル) |
Used to treat the flu or Parkinson's disease; may decrease milk supply(A型インフルエンザ、パーキンソン症候群) |
Amiodarone |
Cordarone(アンカロン) |
Used to treat heart problems(抗不整脈) |
Cancer drugs
(抗ガン剤) |
|
|
Cocaine |
|
|
Clozapine |
Clozaril |
Used to treat schizophrenia |
Gold Salts |
Myochrysine |
Used to treat arthritis |
Iodide(ヨウ化物) |
Betadine |
Used for douching |
Lipid-lowering drugs(高脂血症治療薬) |
Baycol, Lescol(ローコール), Lipitor(リピトール), Lopid, Mevacor, Pravacor(メバロチン), Zocor(リポバス) |
Used to lower the level of fats in the blood |
Metamizole (Dipyrone) |
|
Analgesic/anti-inflammatory. Banned in U.S. but available in Mexico |
Salicyclates, large doses (サリチル酸高用量) |
Aspirin(アスピリン高用量) |
Used to treat arthritis |
|
|
|
|
<資料2>
PEDIATRICS Vol. 108 No. 3 September 2001, pp. 776-789
AMERICAN ACADEMY OF PEDIATRICS:
The Transfer of Drugs and Other Chemicals Into Human Milk
(母乳への薬物移行)
Committee on Drugs
(2001アメリカ小児科学会薬事委員会)
|
TABLE 6
Maternal Medication Usually Compatible With Breastfeeding* (母乳育児中の投与として通常適切)
|
Drug |
Reported Sign or Symptom in Infant or Effect on Lactation |
Reference No. |
|
Acetaminophen |
None |
142-144 |
Acetazolamide |
None |
145 |
Acitretin |
|
146 |
Acyclovir |
None |
147, 148 |
Alcohol (ethanol) |
With large amounts, drowsiness, diaphoresis, deep sleep, weakness, decrease in linear growth, abnormal weight gain; maternal ingestion of 1 g/kg daily decreases milk ejection reflex |
4, 149-152 |
Allopurinol |
|
153 |
Amoxicillin |
None |
154 |
Antimony |
|
155 |
Atropine |
None |
156 |
Azapropazone (apazone) |
|
157 |
Aztreonam |
None |
158 |
B1 (thiamin) |
None |
159 |
B6 (pyridoxine) |
None |
160-162 |
B12 |
None |
163 |
Baclofen |
None |
164 |
Barbiturate |
See Table 5 |
Bendroflumethiazide |
Suppresses lactation |
165 |
Bishydroxycoumarin (dicumarol) |
None |
166 |
Bromide |
Rash, weakness, absence of cry with maternal intake of 5.4 g/d |
167 |
Butorphanol |
None |
168 |
Caffeine |
Irritability, poor sleeping pattern, excreted slowly; no effect with moderate intake of caffeinated beverages (2-3 cups per day) |
169-174 |
Captopril |
None |
175 |
Carbamazepine |
None |
176, 177 |
Carbetocin |
None |
178 |
Carbimazole |
Goiter |
83, 179, 180 |
Cascara |
None |
181 |
Cefadroxil |
None |
154 |
Cefazolin |
None |
182 |
Cefotaxime |
None |
183 |
Cefoxitin |
None |
183 |
Cefprozil |
|
184 |
Ceftazidime |
None |
185 |
Ceftriaxone |
None |
186 |
Chloral hydrate |
Sleepiness |
187 |
Chloroform |
None |
188 |
Chloroquine |
None |
189-191 |
Chlorothiazide |
None |
192, 193 |
Chlorthalidone |
Excreted slowly |
194 |
Cimetidine |
None |
195, 196 |
Ciprofloxacin |
None |
197, 198 |
Cisapride |
None |
199 |
Cisplatin |
Not found in milk |
30 |
Clindamycin |
None |
200 |
Clogestone |
None |
201 |
Codeine |
None |
144, 156, 202 |
Colchicine |
|
203-205 |
Contraceptive pill with estrogen/progesterone |
Rare breast enlargement; decrease in milk production and protein content (not confirmed in several studies) |
206-213 |
Cycloserine |
None |
214 |
D (vitamin) |
None; follow up infant's serum calcium level if mother receives pharmacologic doses |
215-217 |
Danthron |
Increased bowel activity |
218 |
Dapsone |
None; sulfonamide detected in infant's urine |
191, 219 |
Dexbrompheniramine maleate with d-isoephedrine |
Crying, poor sleeping patterns, irritability |
220 |
Diatrizoate |
None |
221 |
Digoxin |
None |
222, 223 |
Diltiazem |
None |
224 |
Dipyrone |
None |
225 |
Disopyramide |
None |
226, 227 |
Domperidone |
None |
228 |
Dyphylline |
None |
229 |
Enalapril |
|
230 |
Erythromycin (エリスロシン) |
None |
231 |
Estradiol |
Withdrawal, vaginal bleeding |
232 |
Ethambutol |
None |
214 |
Ethanol (cf. alcohol) |
|
|
Drug(Maternal Medication Usually Compatible With Breastfeeding* ) |
Reported Sign or Symptom in Infant or Effect on Lactation |
Reference No. |
|
Ethosuximide |
None, drug appears in infant serum |
176, 233 |
Fentanyl |
|
234 |
Fexofenadine |
None |
235 |
Flecainide |
|
236, 237 |
Fleroxacin |
One 400-mg dose given to nursing mothers; infants not given breast milk for 48 h |
238 |
Fluconazole |
None |
239 |
Flufenamic acid |
None |
240 |
Fluorescein |
|
241 |
Folic acid |
None |
242 |
Gadopentetic (Gadolinium) |
None |
243 |
Gentamicin |
None |
244 |
Gold salts |
None |
245-249 |
Halothane |
None |
250 |
Hydralazine |
None |
251 |
Hydrochlorothiazide |
|
192, 193 |
Hydroxychloroquine |
None |
252, 253 |
Ibuprofen |
None |
254, 255 |
Indomethacin |
Seizure (1 case) |
256-258 |
Iodides |
May affect thyroid activity; see iodine |
259 |
Iodine |
Goiter |
259 |
Iodine (povidone-iodine, eg, in a vaginal douche) |
Elevated iodine levels in breast milk, odor of iodine on infant's skin |
259 |
Iohexol |
None |
97 |
Iopanoic acid |
None |
260 |
Isoniazid |
None; acetyl (hepatotoxic) metabolite secreted but no hepatotoxicity reported in infants |
214, 261 |
Interferon- |
|
262 |
Ivermectin |
None |
263, 264 |
K1 (vitamin) |
None |
265, 266 |
Kanamycin |
None |
214 |
Ketoconazole |
None |
267 |
Ketorolac |
|
268 |
Labetalol |
None |
269, 270 |
Levonorgestrel |
|
271-274 |
Levothyroxine |
None |
275 |
Lidocaine |
None |
276 |
Loperamide |
|
277 |
Loratadine |
None |
278 |
Magnesium sulfate |
None |
279 |
Medroxyprogesterone |
None |
201, 280 |
Mefenamic acid |
None |
281 |
Meperidine |
None |
61, 282 |
Methadone |
None |
283-287 |
Methimazole (active metabolite of carbimazole) |
None |
288, 289 |
Methohexital |
None |
61 |
Methyldopa |
None |
290 |
Methyprylon |
Drowsiness |
291 |
Metoprolol |
None |
120 |
Metrizamide |
None |
292 |
Metrizoate |
None |
97 |
Mexiletine |
None |
293, 294 |
Minoxidil |
None |
295 |
Morphine |
None; infant may have measurable blood concentration |
282, 296-298 |
Moxalactam |
None |
299 |
Nadolol |
None |
300 |
Nalidixic acid |
Hemolysis in infant with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency |
301 |
Naproxen |
|
302 |
Nefopam |
None |
303 |
Nifedipine |
|
304 |
Nitrofurantoin |
Hemolysis in infant with G-6-PD deficiency |
305 |
Norethynodrel |
None |
306 |
Norsteroids |
None |
307 |
Noscapine |
None |
308 |
Ofloxacin |
None |
198 |
Oxprenolol |
None |
309, 310 |
Phenylbutazone |
None |
311 |
Phenytoin |
Methemoglobinemia (1 case) |
138, 176, 312 |
Piroxicam |
None |
313 |
Prednisolone
(プレドニン)
|
None |
314, 315 |
Prednisone
(プレドニン)
|
None |
316 |
|
Drug(Maternal Medication Usually Compatible With Breastfeeding* ) |
Reported Sign or Symptom in Infant or Effect on Lactation |
Reference No. |
|
Procainamide |
None |
317 |
Progesterone |
None |
318 |
Propoxyphene |
None |
319 |
Propranolol |
None |
320-322 |
Propylthiouracil |
None |
323 |
Pseudoephedrine |
None |
324 |
Pyridostigmine |
None |
325 |
Pyrimethamine |
None |
326 |
Quinidine |
None |
191, 327 |
Quinine |
None |
296 |
Riboflavin |
None |
159 |
Rifampin |
None |
214 |
Scopolamine |
|
156 |
Secobarbital |
None |
328 |
Senna |
None |
329 |
Sotalol |
|
237, 330 |
Spironolactone |
None |
331 |
Streptomycin |
None |
214 |
Sulbactam |
None |
332 |
Sulfapyridine |
Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant's milk |
333, 334 |
Sulfisoxazole |
Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant's milk |
335 |
Sumatriptan |
None |
336 |
Suprofen |
None |
337 |
Terbutaline |
None |
338 |
Terfenadine |
None |
235 |
Tetracycline |
None; negligible absorption by infant |
339, 340 |
Theophylline
(テオドール、ユニコン)
|
Irritability |
169, 341 |
Thiopental |
None |
139, 342 |
Thiouracil |
None mentioned; drug not used in United States |
343 |
Ticarcillin |
None |
344 |
Timolol |
None |
310 |
Tolbutamide |
Possible jaundice |
345 |
Tolmetin |
None |
346 |
Trimethoprim/sulfamethoxazole |
None |
347, 348 |
Triprolidine |
None |
324 |
Valproic acid |
None |
176, 349, 350 |
Verapamil |
None |
351 |
Warfarin |
None |
352 |
Zolpidem |
None |
353 |
|
* Drugs listed have been reported in the literature as having the effects listed or no effect. The word "none" means that no observable change was seen in the nursing infant while the mother was ingesting the compound. Dashes indicate no mention of clinical effect on the infant. It is emphasized that many of the literature citations concern single case reports or small series of infants. |
Drug is concentrated in human milk. |
|
|
TABLE 5
Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution* (注意して投与すべき)
|
Drug |
Reported Effect |
Reference No. |
|
Acebutolol |
Hypotension; bradycardia; tachypnea |
116 |
5-Aminosalicylic acid |
Diarrhea (1 case) |
117-119 |
Atenolol |
Cyanosis; bradycardia |
120-124 |
Bromocriptine |
Suppresses lactation; may be hazardous to the mother |
125, 126 |
Aspirin (salicylates) |
Metabolic acidosis (1 case) |
127-129 |
Clemastine |
Drowsiness, irritability, refusal to feed, high-pitched cry, neck stiffness (1 case) |
130 |
Ergotamine |
Vomiting, diarrhea, convulsions (doses used in migraine medications) |
131 |
Lithium |
One-third to one-half therapeutic blood concentration in infants |
132-134 |
Phenindione |
Anticoagulant: increased prothrombin and partial thromboplastin time in 1 infant; not used in United States |
135 |
Phenobarbital |
Sedation; infantile spasms after weaning from milk containing phenobarbital, methemoglobinemia (1 case) |
136-140 |
Primidone |
Sedation, feeding problems |
136, 137 |
Sulfasalazine (salicylazosulfapyridine) |
Bloody diarrhea (1 case) |
141 |
|
* Blood concentration in the infant may be of clinical importance. |
|
|
TABLE 4
Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern* (未確認だが注意が必要)
|
Drug |
Reported or Possible Effect |
Reference No. |
|
Anti-anxiety |
Alprazolam |
None |
57 |
Diazepam |
None |
58-62 |
Lorazepam |
None |
63 |
Midazolam |
|
64 |
Perphenazine |
None |
65 |
Prazepam |
None |
66 |
Quazepam |
None |
67 |
Temazepam |
|
68 |
Antidepressants |
Amitriptyline |
None |
69, 70 |
Amoxapine |
None |
71 |
Bupropion |
None |
72 |
Clomipramine |
None |
73 |
Desipramine |
None |
74, 75 |
Dothiepin |
None |
76, 77 |
Doxepin |
None |
78 |
Fluoxetine |
Colic, irritability, feeding and sleep disorders, slow weight gain |
79-87 |
Fluvoxamine |
|
88 |
Imipramine |
None |
74 |
Nortriptyline |
None |
89, 90 |
Paroxetine |
None |
91 |
Sertraline |
None |
92, 93 |
Trazodone |
None |
94 |
Antipsychotic |
Chlorpromazine |
Galactorrhea in mother; drowsiness and lethargy in infant; decline in developmental scores |
95-98 |
Chlorprothixene |
None |
99 |
Clozapine |
None |
100 |
Haloperidol |
Decline in developmental scores |
101-104 |
Mesoridazine |
None |
105 |
Trifluoperazine |
None |
104 |
OTHERS |
Amiodarone |
Possible hypothyroidism |
106 |
Chloramphenicol |
Possible idiosyncratic bone marrow suppression |
107, 108 |
Clofazimine |
Potential for transfer of high percentage of maternal dose; possible increase in skin pigmentation |
109 |
Lamotrigine |
Potential therapeutic serum concentrations in infant |
110 |
Metoclopramide |
None described; dopaminergic blocking agent |
111, 112 |
Metronidazole |
In vitro mutagen; may discontinue breastfeeding for 12-24 h to allow excretion of dose when single-dose therapy given to mother |
113, 114 |
Tinidazole |
See metronidazole |
115 |
|
* Psychotropic drugs, the compounds listed under anti-anxiety, antidepressant, and antipsychotic categories, are of special concern when given to nursing mothers for long periods. Although there are very few case reports of adverse effects in breastfeeding infants, these drugs do appear in human milk and, thus, could conceivably alter short-term and long-term central nervous system function.56 See discussion in text of psychotropic drugs. |
Drug is concentrated in human milk relative to simultaneous maternal plasma concentrations. |
|
|
TABLE 1
Cytotoxic Drugs That May Interfere With Cellular Metabolism of the Nursing Infant
(乳児の細胞代謝に毒性的に働く即ち禁忌)
|
|
Drug |
Reason for Concern, Reported Sign or Symptom in Infant, or
Effect on Lactation |
Reference No. |
|
Cyclophosphamide |
Possible immune suppression; unknown effect on growth or
association with carcinogenesis; neutropenia |
26, 27 |
Cyclosporine |
Possible immune suppression; unknown effect on growth or
association with carcinogenesis |
28, 29 |
Doxorubicin* |
Possible immune suppression; unknown effect on growth or
association with carcinogenesis |
30 |
Methotrexate |
Possible immune suppression; unknown effect on growth or
association with carcinogenesis; neutropenia |
31 |
|
* Drug is concentrated in human milk. |
|
|