Kristensen J H, Ilett Kenneth F, Rampono Jonathan, Kohan Rolland, Hackett L Peter
Pharmacy Department, Women's and Children's Health Service, Subiaco, Australia.
Br J Clin Pharmacol. 2007 Mar;63(3):322-7. doi: 10.1111/j.1365-2125.2006.02773.x. Epub 2006 Sep 13.
To investigate the transfer of mirtazapine and desmethylmirtazapine into milk and to calculate dose to the infant via milk.
Plasma and milk samples were obtained from eight breast-feeding women who were taking a median dose of 38 mg mirtazapine per day. Milk/plasma ratio (M/P) and infant doses were estimated by standard methods. The infants were examined clinically and in four infants blood was taken for analysis.
Mean (95% confidence interval) relative infant doses for mirtazapine and desmethylmirtazapine (n = 8) were 1.5% (0.8, 2.2) and 0.4% (0.2, 0.6) respectively. The mean M/P (area under curve n = 4, single or paired samples n = 3) was 1.1 (0.7,1.5) for mirtazapine and 0.6 (0.5, 0.7) for desmethylmirtazapine. No adverse effects were seen. Mirtazapine was detected (1.5 microg l(-1)) in only one of four infants tested.
We suggest that mirtazapine use by lactating women is safe for the breast-fed infant. Nevertheless, each decision to breast feed should always be made on the basis of an individual risk/benefit analysis.
研究米氮平和去甲米氮平向乳汁中的转移情况，并计算通过乳汁给予婴儿的剂量。
从8名正在服用米氮平的哺乳期妇女中采集血浆和乳汁样本，这些妇女米氮平的中位剂量为每日38毫克。采用标准方法估算乳汁/血浆比值（M/P）和婴儿剂量。对婴儿进行临床检查，4名婴儿采集血样进行分析。
米氮平和去甲米氮平（n = 8）的平均（95%置信区间）相对婴儿剂量分别为1.5%（0.8，2.2）和0.4%（0.2，0.6）。米氮平的平均M/P（曲线下面积n = 4，单样本或配对样本n = 3）为1.1（0.7，1.5），去甲米氮平为0.6（0.5，0.7）。未观察到不良反应。在4名接受检测的婴儿中，仅1名婴儿检测到米氮平（1.5微克/升）。
我们认为哺乳期妇女使用米氮平对母乳喂养的婴儿是安全的。然而，每次母乳喂养的决定都应基于个体的风险/效益分析。
