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Distribution and excretion of sumatriptan in human milk
Author(s) -
WOJNARHORTON R. E.,
HACKETT L. P.,
YAPP P.,
DUSCI L. J.,
PAECH M.,
ILETT K. F.
Publication year - 1996
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1996.tb00185.x
Subject(s) - breast milk , pharmacokinetics , medicine , excretion , bioavailability , breast feeding , sumatriptan , volunteer , infant formula , endocrinology , physiology , zoology , pharmacology , chemistry , pediatrics , agonist , biology , biochemistry , receptor , agronomy
1 The excretion of a 6 mg subcutaneous dose of sumatriptan in breast milk was studied in five lactating volunteer subjects with a mean age of 27.6 years and a mean body weight of 75 kg. Drug concentrations in milk and plasma over the ensuing 8 h were measured by high‐performance liquid chromatography. 2 The mean milk:plasma ratio estimated from the areas under the milk and plasma concentration‐time curves (AUC) was 4.9 (95% CI 4.1–5.7), indicating a significant transfer of sumatriptan into the milk compartment. 3 The mean total recovery of drug in milk was estimated to be only 14.4 μg (95% CI 6.1–22.7 μg), or 0.24% of the 6 mg administered dose. On a weight‐adjusted basis this corresponded to a mean infant exposure of 3.5% of the maternal dose (95% CI 0.3–6.7%). 4 If oral bioavailability in the infant is similar to that in adults (14%), the weight‐adjusted infant dose is reduced to 0.49%. Furthermore, allowance for reduced clearance in the infant predicts an infant exposure varying from 4.9% in a very premature neonate to 0.7% in a 30 week old infant. 5 Since sumatriptan is usually administered as a single dose at infrequent intervals, the low level of excretion in breast milk suggests that continued breast feeding following its use will not pose a significant risk to the suckling infant. Even this minor exposure could be largely avoided by expressing and discarding all milk for 8 h after the dose.