Nursing women

Antimicrobial agents must be used with caution in pregnant and nursing women. Some agents are either known or likely to be teratogenic (e.g., metronidazole), and others pose... 

MTX is contraindicated in pregnant and nursing women, chronic liver disease, immunodeficiency, pleural or peritoneal effusions, leukopenia, thrombocytopenia, preexisting blood disorders, and creatinine clearance <40 mL/min. 

Finally, specific standard values for pregnant and nursing women are also recommended, as well as for activity at various ambient temperatures (see Table 7.10). 

All HMG-CoA reductase inhibitors are contraindicated in pregnant and nursing women. When ezetimibe is administered with an HMG-CoA reductase inhibitor in a woman of childbearing potential, refer to the pregnancy category and product labeling for the HMG-CoA reductase inhibitor. 

Lactation It is not known if daptomycin is excreted in human milk. Exercise caution when administering daptomycin to nursing women. 

Headache and GI symptoms are the most frequently reported side effects. It is possible to reduce GI side effects, such as nausea, abdominal discomfort, and diarrhea, by taking the extract with food. Theoretically, decreased libido or erectile dysfunction could also occur. Because of saw palmetto s possible hormonal effects (and lack of indications for use), pregnant and nursing women should avoid it. It is important to rule out prostate cancer in those taking saw palmetto for BPH, since the symptoms are similar. The effect of saw palmetto on prostatic cancer would likely be beneficial but not curative. No drug interactions have been reported. 

Pregnant or nursing women exposed to methylmercury through their diet or otherwise also expose their developing fetus or breast-fed infant to the chemical, since methylmercury passes through placental membranes and enters the fetal bloodstream, and also enters breast milk. This is particularly problematic since fetuses and infants (and toddlers) are more susceptible and sensitive to the neurotoxic properties of mercury than are adults. 

Levels will be highest for children living in the vicinity of the area affected by the Michigan contamination episode. The most important pathway appears to be consumption of contaminated mother s milk (see Section 6.4.4). Mere data are needed on the levels of PBB exposure in nursing women from consumption of fish and from those of the general population. Exposure and body burden... 

Ohta S, Ishizuke D, Nishimura H, et al. 2002. Comparison of polybrominted diphenyl ethers in fish, vergetables, and meats and levels in human milk of nursing women in Japan. Chemosphere 46(5) 689-696. 

Adults, particularly pregnant or nursing women, also require vitamin D because calcium and phosphorus are continually dissolving from bones and vitamin D is necessary for their utilization. Rickets is not to be confused with the entirely unrelated Rickeetsial group of diseases (Rocky Mountain fever, etc.) that are of virus origin. 

Croxatta, H.B., et al. 1982. Fertility regulation in nursing women. II. Comparative performance of progesterone implants versus placebo and copper T. Am J Obstet Gynecol 144 201. 

Massai, R., et al. 1999. Pre-registration study on the safety and contraceptive efficacy of a progesterone-releasing vaginal ring on Chilean nursing women. Contraception 60 9. 

Most studies find that moderate use of caffeine does not impair fertility, risk miscarriage, or increase the chance of having a baby with birth defects. The March of Dimes has concluded that moderate caffeine is of low risk to pregnant and nursing women. 

In investigations in nursing women, excretion of the drug or its metabolites into human milk should be examined where applicable. When nursing mothers are enrolled in clinical studies, their infants should be monitored for the effects of the drug. 

When blood and milk were sampled in 22 nursing women taking sertraline (25-200 mg/day), sertraline and its metabolite, desmethylsertraline, were found in all the milk samples (89). The maximum concentration of sertraline and desmethylsertraline in the milk occurred 8-9 hours after maternal ingestion of the daily dose of sertraline. Eleven infants had detectable desmethylsertraline of these, four also had detectable sertraline. No adverse effects were noted in any of the children. The authors calculated that the infants had received on average about 0.5% of the maternal sertraline dose. 

Contraindications for homatropine are essentially the same as for atropine. As with atropine, very small amounts of homatropine have been detected in breast milk. According to the American Academy of Pediatrics, however, homatropine use is compatible with breast-feeding, but caution should be exercised when administering homatropine to nursing women. As with topical administration of atropine, homatropine can also induce CNS toxicity in the elderly. 

Dilation in Pregnant and Nursing Women Narrow Angle With Intact Iris... 

---