To nurse when receiving acebutolol: Is it dangerous for the neonate?
- 38 Downloads
The concentrations of acebutolol and of its main active metabolite diacetolol in milk and plasma were studied in 7 hypertensive mothers treated with acebutolol, a cardioselective β-adrenoceptor blocking agent. Clinical monitoring on their newborn babies was also done, as well as measurement of plasma level of the drug in them. The ratio between milk and plasma concentrations ranged from 1.9 to 9.2 for acebutolol and from 2.3 to 24.7 for diacetolol, and in any given milk sample, the diacetolol concentration was always higher than that of acebutolol. In a newborn infant, plasma concentrations of the two transplacentally acquired substances was raised when breast feeding started and remained high. Clinical signs of pharmacological β-blockade were observed. Evaluation of the iatrogenic risk shows that pharmacologically active amounts of acebutolol might be received by a neonate if the daily maternal dosage exceeds 400 mg/day and/or renal function in the mother is impaired.
Key wordsacebutolol neonates beta-blocking agents perinatal pharmacology excretion in milk transplacental passage diacetolol neonatal beta-blockade
Unable to display preview. Download preview PDF.
- 1.Bauer JH, Pape B, Zajicek J, Groshong T (1979) Propranolol in human plasma and breast milk. Am J Cardiol 43: 860–862Google Scholar
- 2.Boutroy MJ, Vert P, Bianchetti G, Dubruc C, Morselli PL (1982) Infants born to hypertensive mothers treated by acebutolol. Pharmacological studies in the perinatal period. Dev Pharmacol Ther 4 [Suppl 1]: 109–115Google Scholar
- 3.Collins RF (1975) Pharmacocinétique de l'acébutolol. Nouv Presse Méd 4: 3323–3328Google Scholar
- 4.Devlin RG, Fleiss PM (1981) Nadolol excretion in human milk. Proceedings of the eithty-second annual meeting of the American Society for Clinical Pharmacology and Therapeutics, New Orleans, March 19–21Google Scholar
- 5.Dumez Y, Tchobroutsky C, Hornych H, Amiel-Tison C (1981) Neonatal effects of maternal administration of acebutolol. Br Med J 283: 1977–1979Google Scholar
- 6.Gillette P, Garson A, Eterovic E, Neches N, Mullins C, McNamara DG (1978) Oral propranolol treatment in infants and children. J Pediatr 92: 141–144Google Scholar
- 7.Karlberg B, Lundberg D, Aberg H (1974) Excretion of propranolol in human breast milk. Acta Pharmacol 34: 222–224Google Scholar
- 8.Liedholm H, Melander A, Bitzen PO, Helm G, Lonnerholm G, Mattiason J, Nilsson B, Wåhlin-Boll E (1981) Accumulation of atenolol and metoprolol in human breast milk. Eur J Clin Pharmacol 20: 229–231Google Scholar
- 9.O'Hare MF, Murnaghan GA, Russel CJ, Leahey WJ, Varma MPS, McDevitt DG (1980) Sotalol as a hypotensive agent in pregnancy. Br J Obstet Gynaecol 87: 814–820Google Scholar
- 11.Roux A, Aubert P, Guedon J, Flouvat B (1980) Pharmacokinetics of acebutolol in patients with all grades of renal failure. Eur J Clin Pharmacol 17: 339–348Google Scholar
- 11.Sandstrom B, Regardh CG (1980) Metoprolol excretion into breast milk. Br J Clin Pharmacol 9: 518–519Google Scholar
- 12.Tunstall ME (1969) The effect of propranolol on the onset of breathing at birth. Br J Anaesth 41: 792Google Scholar