Maternal Metyrapone Use During Breastfeeding: Safe for the Breastfed Infant.
J Endocr Soc
; 3(5): 973-978, 2019 May 01.
Article
em En
| MEDLINE
| ID: mdl-31041428
ABSTRACT
CONTEXT Metyrapone is an inhibitor of endogenous adrenal corticosteroid synthesis, which has been proven to be a viable option in controlling maternal serum cortisol concentrations during pregnancy. The infant exposure to maternally ingested metyrapone through breast milk is, however, largely unknown. CASE DESCRIPTION We report the excretion of metyrapone into breast milk and subsequent infant exposure from a lactating woman on 250 mg of metyrapone three times daily. Due to limited supply of breast milk, the infant was fed â¼50% breast milk and 50% formula. At steady state, the average concentrations in the studied breast milk and absolute and relative infant doses were 176 µg/L, 26.45 µg/kg/d, and 0.7%, respectively, for metyrapone, and 310 µg/L, 46.52 µg/kg/d, and 1.21% for its active metabolite metyrapol. The breastfed infant was found to have a plasma metyrapone concentration of 0.05 µg/L, with no evidence of disruption to his adrenocortical axis biochemically. CONCLUSION:
These findings indicate that maternal metyrapone use during breastfeeding did not pose a notable risk to this breastfed infant. The infants' exposure to metyrapone was further minimized by avoiding nursing for 2 to 3 hours after each metyrapone dose.
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MEDLINE
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article