Negligible exposure to nifurtimox through breast milk during maternal treatment for Chagas Disease

Background: Treatment with nifurtimox (NF) for Chagas disease is discouraged during breast-feeding because no information on NF transfer into breast milk is available. NF is safe and effective for paediatric and adult Chagas disease. We evaluated the degree of NF transfer into breast milk in lactati...

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Autores principales:	Moroni, Samanta, Marson, María Elena, Moscatelli, Guillermo, Mastrantonio Garrido, Guido Enrique, Bisio, Margarita, González, Nicolás, Ballering, Griselda, Altcheh, Jaime, Garcia Bournissen, Facundo
Formato:	Articulo
Lenguaje:	Inglés
Publicado:	2019
Materias:	Ciencias Médicas Chagas disease Internal medicine Prospective cohort study Breast milk Breastfeeding Blood plasma Nifurtimox Breast feeding Medicine Cohort Gastroenterology
Acceso en línea:	http://sedici.unlp.edu.ar/handle/10915/126176
Aporte de:	SEDICI (UNLP) de Universidad Nacional de La Plata

id	I19-R120-10915-126176
record_format	dspace
institution	Universidad Nacional de La Plata
institution_str	I-19
repository_str	R-120
collection	SEDICI (UNLP)
language	Inglés
topic	Ciencias Médicas Chagas disease Internal medicine Prospective cohort study Breast milk Breastfeeding Blood plasma Nifurtimox Breast feeding Medicine Cohort Gastroenterology
spellingShingle	Ciencias Médicas Chagas disease Internal medicine Prospective cohort study Breast milk Breastfeeding Blood plasma Nifurtimox Breast feeding Medicine Cohort Gastroenterology Moroni, Samanta Marson, María Elena Moscatelli, Guillermo Mastrantonio Garrido, Guido Enrique Bisio, Margarita González, Nicolás Ballering, Griselda Altcheh, Jaime Garcia Bournissen, Facundo Negligible exposure to nifurtimox through breast milk during maternal treatment for Chagas Disease
topic_facet	Ciencias Médicas Chagas disease Internal medicine Prospective cohort study Breast milk Breastfeeding Blood plasma Nifurtimox Breast feeding Medicine Cohort Gastroenterology
description	Background: Treatment with nifurtimox (NF) for Chagas disease is discouraged during breast-feeding because no information on NF transfer into breast milk is available. NF is safe and effective for paediatric and adult Chagas disease. We evaluated the degree of NF transfer into breast milk in lactating women with Chagas disease. Patients and methods: Prospective study of a cohort of lactating women with Chagas disease. Patients were treated with NF for 1 month. NF was measured in plasma and milk by high performance liquid chromatography (HPLC). Breastfed infants were evaluated at admission, 7th and 30th day of treatment (and monthly thereafter, for 6 months). Results: Lactating women with chronic Chagas disease (N = 10) were enrolled (median age 28 years, range 17–36). Median NF dose was 9.75 mg/kg/day three times a day (TID). Six mothers had mild adverse drug reactions (ADRs), but no ADRs were observed in any of the breastfed infants. No interruption of breastfeeding was observed. Median NF concentrations were 2.15 mg/L (Inter quartil range (IQR) 1.32–4.55) in milk and 0.30 mg/L (IQR 0.20–0.95) in plasma. Median NF milk/plasma ratio was 16 (range 8.75–30.25). Median relative infant NF dose (assuming a daily breastmilk intake of 150 mL/kg/day) was 6.7% of the maternal dose/kg/day (IQR 2.35–7.19%). Conclusions: The low concentrations of NF in breast milk and the normal clinical evaluation of the breastfed babies imply that maternal NF treatment for Chagas disease during breastfeeding is unlikely to lead to clinically relevant exposures in the breastfed infants.
format	Articulo Articulo
author	Moroni, Samanta Marson, María Elena Moscatelli, Guillermo Mastrantonio Garrido, Guido Enrique Bisio, Margarita González, Nicolás Ballering, Griselda Altcheh, Jaime Garcia Bournissen, Facundo
author_facet	Moroni, Samanta Marson, María Elena Moscatelli, Guillermo Mastrantonio Garrido, Guido Enrique Bisio, Margarita González, Nicolás Ballering, Griselda Altcheh, Jaime Garcia Bournissen, Facundo
author_sort	Moroni, Samanta
title	Negligible exposure to nifurtimox through breast milk during maternal treatment for Chagas Disease
title_short	Negligible exposure to nifurtimox through breast milk during maternal treatment for Chagas Disease
title_full	Negligible exposure to nifurtimox through breast milk during maternal treatment for Chagas Disease
title_fullStr	Negligible exposure to nifurtimox through breast milk during maternal treatment for Chagas Disease
title_full_unstemmed	Negligible exposure to nifurtimox through breast milk during maternal treatment for Chagas Disease
title_sort	negligible exposure to nifurtimox through breast milk during maternal treatment for chagas disease
publishDate	2019
url	http://sedici.unlp.edu.ar/handle/10915/126176
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bdutipo_str	Repositorios
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Negligible exposure to nifurtimox through breast milk during maternal treatment for Chagas Disease

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