Drug Monitoring in Breast Milk: Novel Insights on Pharmacokinetics and Infant Exposure Estimates
Year: 2018
Type: dissertation
Abstract: The health benefits of breastfeeding are numerous and well described. It has been reported that ~70% of women take medication in the postpartum period; however, little is known about drug excretion into breast milk and infant exposure estimates are often unreliable. This gap in knowledge is due to the fact that women are excluded from clinical trials if they are lactating and carrying out a formal pharmacokinetic study is both ethically and practically challenging. The lack of knowledge and uncertainty on drug safety during lactation causes women to discontinue breastfeeding prematurely in order to take a medication or decide not to initiate breastfeeding altogether. While most drugs are considered to be compatible with breastfeeding, inaccurate infant exposure predictions of drugs in breast milk have led to infant adverse events and even fatalities. The overall aims of this thesis were to investigate the safety of three drugs and their use during lactation: methotrexate, escitalopram, and infliximab. Using a combination of newly developed analytical techniques, in silico methods, and animal lactation models, this thesis helps provide an updated framework for studying the safety of drugs during breastfeeding.
Source: TSpace (University of Toronto)
Author: Sarah Delaney
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2910979701