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Cyclosporine excretion into breast milk
Myla E Moretti1, Michael Sgro, David W Johnson
1The Motherisk Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
Transplantation
|June 28, 2003
Summary
Women receiving cyclosporine can often breast-feed safely, as infant drug levels are typically low. This study observed five mother-infant pairs, finding varied exposures but no adverse effects, challenging previous contraindications.
Area of Science:
- Immunology
- Pharmacology
- Neonatal Care
Background:
- Cyclosporine is an immunosuppressive drug commonly used in organ transplant recipients and for autoimmune diseases.
- Traditionally, cyclosporine use during breastfeeding has been contraindicated due to potential risks to the infant.
- Recent literature suggests successful pregnancies and breastfeeding in women taking cyclosporine, with low infant blood concentrations.
Observation:
- This study reports on five mother-infant pairs where the mother was taking cyclosporine while breastfeeding.
- Infant exposure to cyclosporine through breast milk varied significantly among the observed pairs.
- One infant achieved therapeutic blood concentrations of cyclosporine despite low milk concentrations.
Findings:
- The study observed a wide range of infant cyclosporine exposure via breast milk.
- No adverse effects were detected in the infants during the observation period.
- Infant blood cyclosporine levels were generally low, though one case showed therapeutic levels.
Implications:
- The findings challenge the conventional contraindication of cyclosporine during breastfeeding.
- Suggests that breastfeeding may be a viable option for some women taking cyclosporine, under medical supervision.
- Further research is warranted to establish clear guidelines for cyclosporine use during lactation.