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Kinetics of the translactal passage of digoxin from breast feeding mothers to their infants


In order to find out whether digoxin therapy of nursing mothers might produce discomfort in suckling infants we have investigated the kinetics of the transfer of digoxin from plasma to milk in 11 nursing mothers. After intravenous or oral application of a single dose of 0.5 mg or 0.75 mg digoxin simultaneous serum, fore- and hindmilk samples were taken. Obviously, a rapid equilibrium occurred between the serum and the milk compartments and there was no difference between fore- and hindmilk. All three digoxin concentration profiles ran parallel with a milk to serum ratio of 0.6 to 0.7. The curves could best be fitted by the sum of two exponential functions. For predicting the digoxin intake into the suckling infant, simulations were carried out on the basis of two coupled compartment models.

When the kinetic milk data as well as the kinetic data obtained in infants were fitted by this model it could be shown that even in the case of long half-lives only about 3% of the therapeutic drug levels were reached in the baby. Thus, one can conclude that digoxin accumulation to toxic concentrations should not occur in infants of women treated with appropriate doses of digoxin.

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  1. 1.

    Anderson PO (1979) Drugs and breast feeding. Seminars in Perinatology 3:271–278

  2. 2.

    Chan V, Tse TF, Wong V (1978) Transfer of digoxin across the placenta and into breast milk. Br J Obstet Gynaecol 85:605–609

  3. 3.

    Doherty JE (1973) Digoxin: Present knowledge of pharmacokinetics and pharmacodynamics. Symposium on Digitalis. In: Storstein O (ed). Oslo Gyldendal Norsk Forlag, pp 419–428

  4. 4.

    Larbig D, Haasis R, Kochsiek K (1978) Die Glykosidkonzentration und ihre klinische Bedeutung. Forum cardiologicum. Mannheimer Morgen Großdruckerei und Verlag GmbH, Mannheim

  5. 5.

    Loughnan PM (1978) Digoxin excretion in human breast milk. J Pediatr 92:1019–1020

  6. 6.

    Marcus FI (1973) Metabolism of digoxin in normal man and factors influencing the body distribution. Symposium on Digitalis. In: Storstein O (ed). Oslo Gyldendal Norsk Forlag, pp 112–125

  7. 7.

    Ochs HR, Greenblatt DJ, Bodem G (1980) Single- and multipledose kinetics of intravenous digoxin. Clin Pharm Ther 28:340–345

  8. 8.

    Ohnhaus EE, Spring P, Dettli L (1972) Protein binding of digoxin in human serum. Eur J Clin Pharmacol 5:34

  9. 9.

    Ohnhaus EE (1978) Bioavailability of digoxin in renal insufficiency and heart failure. Cardiac Glycosides “International Symposium”, Bonn, Germany, January 27–29, 1977. In: Bodem G, Dengler H-J (eds). Springer, Berlin Heidelberg New York, pp 181–189

  10. 10.

    Oliver GC, Taxman R, Frederikson R (1973) Influence of congestive heart failure on digoxin blood levels. Symposium on Digitalis. In: Storstein O (ed). Oslo Gyldendal Norsk Forlag, pp 336–347

  11. 11.

    Reinhardt D (1980) Arzneimittel während der Stillzeit. Sozialpädiatrie 2:469–473

  12. 12.

    Reinhardt D, Richter O (1981) Mechanismen des Arzneimittelübergangs in die Muttermilch. Monatsschr Kinderheilk 129:1–6

  13. 13.

    Richter O, Reinhardt D (1980) The transference of drugs from breast-feeding mothers to their infants: a pharmacokinetic model. Biol Res Preg 1:112–117

  14. 14.

    Wettrell G (1976) Digoxin therapy in infants. Acta Paediatr Scand [Suppl] 257:3–28

  15. 15.

    Wettrell G (1977) Distribution and elimination of digoxin in infants. Eur J Clin Pharmacol 11:329–335

  16. 16.

    Windorfer A, Gasteiger H (1978) Stillen und Medikamente. Klin Paediatr 190:219–225

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Author information

Correspondence to D. Reinhardt.

Additional information

To Prof. Dr. G.-A. von Harnack on his 65th birthday

Department of Obstetrics

This work was supported by a grant from the SFB 30 of the Deutsche Forschungsgemeinschaft

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Reinhardt, D., Richter, O., Genz, T. et al. Kinetics of the translactal passage of digoxin from breast feeding mothers to their infants. Eur J Pediatr 138, 49–52 (1982).

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Key words

  • Kinetics
  • Translactal passage
  • Digoxin
  • Breastfed infants