To: Toby Gish
Re: Cefuroxime(Ceftin, Zinacef)
Cefuroxime is just another typical cephalsporin antibiotic that almost
certainly is secreted into human milk, although the amount secreted has not
been published. As with most penicillins and their cousins, the
cepahlosporins, most are quite safe to use in lactating women( assuming
the infant is not allergic to penicillins and cephalsporins).
Cefuroxime is commonly used in infants down to 3 months of age, and has
clear pediatric indications.
One interesting factor that should be known about cefuroxime, is that it
has a STRONG, persistent, bitter taste which could alter the taste of
breastmilk. I do not know this for sure concerting breast milk, but it's
something that should be in the back of your mind while attending this mom.
I'll add it to my next edition.
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Re: Sertraline(Zoloft) -- Antidepressant
I've noted several postings requesting info on this serotonin reuptake
inhibitor(SSRI) used for depression. Shortly after I had sent my "Red Book"
to the printer, a good paper was published in June of 1995. J.Clin.
Psychiatry 56:6, p 243, 1995 (Breastfeeding and Sertraline: A 24 hr Analysis).
Basically, this paper suggests that sertraline is secreted into human milk
at concentrations equal to the mom's plasma levels, however, plasma levels
of sertraline in the infant were too low to be detected.
Although this sounds good, we need to remember that the plasma compartment
is probably not the major depot for this drug, the brain is. At this
point we do not know how much is transferred into the infants brain. So
there is no way to know if these compounds are safe in newborns.
========================================
To: Fiona Coombes
Re: Monoamine Oxidase Inhibitors(Meclobemide)
We do not currently have this drug in the US, so I'd like to address the
MAO family in general. As drug crazy as we Americans are, even we are
scared to death of the MAO inhibitor family of drugs. These drugs inhibit
the normal metabolism of the catecholamines(Norepinephrine, epinephrine,
serotonin, etc) in the human brain, so that tissue levels of these
neurotransmitters increase dramatically. Thats how they work in depressive
illness.
However, the side effects and dangers in this family are incredible.
Patients that ingest cheeses, beers, wines, and many other foods, nasal
sprays, any form of catecholamine, nasal decongestants, etc. risk almost
certain hypertensive crisis, and possibly brain damage, strokes, and
death. This is so serious, that we almost never use these products here,
simply because who knows what the patient might take at home.
This is one family of products that I would clearly say are DEFINITELY
CONTRAINDICATED in lactating women. They're just too dangerous.
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T.W. Hale, Ph.D.
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