拉莫三嗪在产后早期癫痫女性乳汁中的分泌特点及母乳喂养安全性评价

摘要

目的 探讨口服拉莫三嗪的癫痫女性产后药物乳汁分泌特点及母乳喂养的安全性.方法 分析2例妊娠期长期口服拉莫三嗪的癫痫女性患者产后早期(2、3、12、14 d)血浆及乳汁拉莫三嗪药物浓度的连续性监测数据,并计算临床常用的评估婴儿药物暴露的相关指标(M/P值、TID、RID值),评估拉莫三嗪母乳喂养的安全性.结果 产后早期拉莫三嗪在乳汁中的分泌特点与血浆药物浓度相关.拉莫三嗪乳汁药物分泌高峰在服药后2h左右.评估药物暴露的相关指标M/P、TID、RID值变异较大,符合相关文献报道.结论 根据我们有限的临床观察及相关文献复习可以看出,口服拉莫三嗪的癫痫女性进行母乳喂养相对安全.%Objective To explore the milk secretion characteristics of lamotrigine used by women with epilepsy and the safety of breastfeeding.Methods Continuous monitoring data of lamotrigine serum and breast milk samples from two postpartum women with epilepsy at 2,3,12 and 14 d after delivery were analyzed.The lamotrigine serum and breast milk concentrations were used to calculate 3 conventional estimates (M/P,TID and RID) of infant drug exposure during lactation and evaluate the safety of lamotrigine in nursing infants was evaluated.Results The breast milk secretion characteristics of lamotrigine for early postpartum women with epilepsy were associated with plasma drug concentrations.The peak of lamotrigine concentrations in breast milk was at 2 h after drug use.The lamotrigine M/P ratio,TID and RID were highly variable,which was consistent with previous literatures.Conclusion According to our clinical observation data and literature information,lamotrigine is compatible safe for breasffeeding.