SA Pharmacy, Women's and Children's Hospital, North Adelaide, SA 5006, Australia.
School of Pharmacy and Medical Sciences, Reid Building, City East Campus, University of South Australia, Adelaide, SA 5000, Australia.
Drug Des Devel Ther. 2020 Mar 2;14:961-967. doi: 10.2147/DDDT.S239704. eCollection 2020.
This study aimed to quantify the amount of perindopril and its active metabolite perindoprilat present in breast milk and corresponding maternal and infant plasma concentrations.
Prospective, longitudinal, observational.
Tertiary specialist paediatric and obstetric hospital in Adelaide, South Australia.
Breastfeeding women actively treated with perindopril for hypertensive disorders postpartum.
Eight breast milk samples and a single plasma sample were collected from each participant over a 24 hrs period, and plasma samples were taken from eligible breastfed infants. Breast milk and plasma concentrations of perindopril and perindoprilat were analysed using a validated Liquid Chromatography tandem-Mass Spectrometry (LC-MS/MS) method.
Mean breast milk concentrations of perindopril and perindoprilat, Relative Infant Dose (RID) <10%, and Theoretical Infant Dose (TID).
Ten women and three infants participated in the study. The mean concentration of perindopril in breast milk for each participant ranged from 0.003 to 1.2 ng/mL and perindoprilat 0.2-36 ng/mL. RID for perindopril was 0.0005-0.2% and perindoprilat 0.03-4.6%. TID for perindopril was 0.00045-0.18 µg/kg/day and perindoprilat 0.032-5.4 µg/kg/day. Infant plasma levels for perindopril ranged from 0.44 to 1.12 ng/mL and perindoprilat undetectable - 10.14 ng/mL. Maternal reports described normal infant growth and development.
Infant exposure to perindopril and perindoprilat through breast milk is low. However, some infants were found to have plasma perindoprilat concentrations consistent with pharmacodynamic effects. Perindopril may be used in mothers of healthy term infants, provided the infant is carefully monitored.
本研究旨在定量测定脯氨酸和其活性代谢物培哚普利拉在母乳中的含量，以及相应的母血和婴儿血中的浓度。
前瞻性、纵向、观察性研究。
南澳大利亚阿德莱德的一家三级专科儿科和产科医院。
接受脯氨酸治疗产后高血压疾病的哺乳期妇女。
每位参与者在 24 小时内采集 8 份母乳样本和 1 份血浆样本，并从合格的母乳喂养婴儿中采集血浆样本。采用液相色谱串联质谱法（LC-MS/MS）对脯氨酸和培哚普利拉的母乳和血浆浓度进行分析。
脯氨酸和培哚普利拉的平均母乳浓度、婴儿相对剂量（RID）<10%和理论婴儿剂量（TID）。
本研究共纳入 10 名产妇和 3 名婴儿。每位参与者的脯氨酸母乳浓度中位数为 0.003 至 1.2ng/ml，培哚普利拉为 0.2 至 36ng/ml。脯氨酸的 RID 为 0.0005 至 0.2%，培哚普利拉为 0.03 至 4.6%。脯氨酸的 TID 为 0.00045 至 0.18μg/kg/d，培哚普利拉为 0.032 至 5.4μg/kg/d。婴儿血中脯氨酸浓度为 0.44 至 1.12ng/ml，培哚普利拉为无法检出至 10.14ng/ml。母亲报告描述了婴儿的正常生长和发育。
婴儿通过母乳暴露于脯氨酸和培哚普利拉的程度较低。然而，一些婴儿的血浆培哚普利拉浓度与药效学作用一致。脯氨酸可用于健康足月婴儿的母亲，只要婴儿得到仔细监测。
