Begg E J, Robson R A, Gardiner S J, Hudson L J, Reece P A, Olson S C, Posvar E L, Sedman A J
Department of Clinical Pharmacology, Christchurch School of Medicine, New Zealand.
Br J Clin Pharmacol. 2001 May;51(5):478-81. doi: 10.1046/j.1365-2125.2001.01327.x.
To measure the milk to plasma ratio (M/P) of quinapril and its active metabolite quinaprilat in lactating mothers and to assess likely infant exposure.
A single dose of quinapril 20 mg was administered to six healthy mothers who had been breastfeeding their infants for at least 2 weeks. Blood was sampled for the measurement of quinapril and quinaprilat at 0, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 16 and 24 h. Milk was collected for measurement of quinapril and quinaprilat concentrations over the periods -4-0, 0-4, 4-8, 8-12, 12-18, 18-24 h. The areas under the plasma and milk concentration-time curves were estimated and an M/P ratio derived for both quinapril and quinaprilat.
The M/P ratio for quinapril was 0.12 (95% CI 0.09,0.14). No quinapril was detected in milk after 4 h. No quinaprilat was detected in any of the milk samples. The estimated 'dose' of quinapril that would be received by the infant was 1.6% (95% CI 1.0,2.2) of the maternal dose, adjusted for respective weights.
Quinapril appears to be 'safe' during breastfeeding according to conventional criteria, although as always, the risk:benefit ratio should be considered when it is to be given to a nursing mother.
测定哺乳期母亲体内喹那普利及其活性代谢产物喹那普利拉的乳浆比（M/P），并评估婴儿可能的暴露情况。
对6名已母乳喂养婴儿至少2周的健康母亲给予单剂量20 mg喹那普利。在0、0.5、1、1.5、2、3、4、6、8、12、16和24小时采集血样以测定喹那普利和喹那普利拉。在-4至0、0至4、4至8、8至12、12至18、18至24小时期间收集乳汁以测定喹那普利和喹那普利拉浓度。估计血浆和乳汁浓度-时间曲线下面积，并得出喹那普利和喹那普利拉的M/P比值。
喹那普利的M/P比值为0.12（95%可信区间0.09,0.14）。4小时后乳汁中未检测到喹那普利。任何乳汁样本中均未检测到喹那普利拉。根据各自体重调整后，婴儿接受的喹那普利估计“剂量”为母亲剂量的1.6%（95%可信区间1.0,2.2）。
按照传统标准，喹那普利在母乳喂养期间似乎“安全”，不过，给哺乳期母亲用药时，一如既往，应考虑风险效益比。
