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Risk to the breast-fed neonate from codeine treatment to the mother: a quantitative mechanistic modeling study
S Willmann1, A N Edginton, K Coboeken
1Competence Center Systems Biology, Bayer Technology Services GmbH, Leverkusen, Germany. stefan.willmann@bayertechnology.com
Abstract:
Administering codeine to breast-feeding mothers had been considered safe until the recent death of a breast-fed neonate whose mother had been prescribed codeine. We investigated the risk of opioid poisoning to breast-fed neonates using coupled physiologically based pharmacokinetic models for the mother and child. Neonatal morphine plasma concentrations were simulated for various combinations of cytochrome P450 2D6 (CYP2D6) genotype and morphine clearance, assuming typical breast-feeding schedules and maternal codeine doses of
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