Is use of nifurtimox for the treatment of Chagas disease compatible with breast feeding? A population pharmacokinetics analysis.

Détails

ID Serval
serval:BIB_D46D8B66ABD6
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Is use of nifurtimox for the treatment of Chagas disease compatible with breast feeding? A population pharmacokinetics analysis.
Périodique
Archives of Disease In Childhood
Auteur(s)
Garcia-Bournissen F., Altcheh J., Panchaud A., Ito S.
ISSN
1468-2044[electronic], 0003-9888[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
95
Numéro
3
Pages
224-228
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Introduction Women with Chagas disease receiving treatment with nifurtimox are discouraged from breast feeding. Many patients who would receive treatment with nifurtimox live in extreme poverty, have limited access to resources such as clean water and baby formula and may not have safe alternatives to breast milk. Aim We aimed to estimate, using limited available pharmacokinetics data, potential infant exposure to nifurtimox through breast milk. Methods Original nifurtimox plasma concentrations were obtained from published studies. Pharmacokinetic parameters were estimated using non-linear mixed-effect modelling with NONMEM V.VI. A total of 1000 nifurtimox plasma-concentration profiles were simulated and used to calculate the amount of drug that an infant would be exposed to, if breast fed 150 ml/kg/day. Results Breast milk concentrations on the basis of peak plasma levels (1361 ng/ml) and milk-plasma ratio were estimated. We calculated infant nifurtimox exposure of a breastfed infant of a mother treated with this drug to be below 10% of the maternal weight-adjusted dose, even if milk-plasma ratio were overestimated. Simulation led to similar estimates. Discussion Risk for significant infant exposure to nifurtimox through breast milk seems small and below the level of exposure of infants with Chagas disease receiving nifurtimox treatment. This potential degree of exposure may not justify discontinuation of breast feeding.
Mots-clé
Pediatric Pharmacology, Chagas Disease, Nifurtimox, Breastfeeding
Pubmed
Web of science
Création de la notice
10/02/2010 15:10
Dernière modification de la notice
20/08/2019 15:54
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