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Transfer of triptans into human breast milk and estimation of infant drug exposure through breastfeeding
Author(s) -
Amundsen Siri,
Nordeng Hedvig,
Fuskevåg OleMartin,
Nordmo Elisabet,
Sager Georg,
Spigset Olav
Publication year - 2021
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.13579
Subject(s) - breastfeeding , breast milk , triptans , human breast milk , breast feeding , medicine , drug , infant formula , obstetrics , pharmacology , pediatrics , anesthesia , migraine , chemistry , biochemistry
Clinical data on the transfer of triptans into human breast milk remain scarce. In a lactation study including 19 breastfeeding women with migraine, we examined the excretion of six different triptans into milk. Following intake of a single dose, each participant collected seven breast milk samples at predefined intervals up to 24 hours after dose. Triptan concentrations in milk were measured using liquid chromatography‐tandem mass spectrometry (LC‐MS/MS). Infant drug exposure was estimated by calculating the relative infant dose (RID). Twenty‐two breast milk sample sets were obtained for sumatriptan (n = 8), rizatriptan (n = 5), zolmitriptan (n = 4), eletriptan (n = 3), almotriptan (n = 1) and naratriptan (n = 1). Based on the average concentration in milk throughout the day, estimated mean RIDs (with range in parenthesis) were as follows: eletriptan 0.6% (0.3%‐0.8%), sumatriptan 0.7% (0.2%‐1.8%), rizatriptan 0.9% (0.3%‐1.4%), almotriptan 1.8% (‐), zolmitriptan 2.1% (0.7%‐5.3%) and naratriptan 5.0% (‐). Infant drug exposure through breastfeeding appears to be low and indicates that use of the triptans in this study is compatible with breastfeeding. Naratriptan may not be first choice in breastfeeding mothers initiating triptans during the neonatal period.