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Subject:
From:
Anna Swisher <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 6 Jul 2001 21:57:09 -0500
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From Medscape.  The article is quite lengthy; here is the abstract:  The URL
is:
http://pediatrics.medscape.com/PP/Pharmacotherapy/2001/v21.n06/pharm2106.03.
gerk/pharm2106.03.gerk-01.html  (you need to register for Medscape).

Abstract
Study Objective. To determine the extent to which nitrofurantoin is
transferred into human milk.
Design. Prospective, single-dose pharmacokinetic study.
Setting. University-affiliated clinical research center.
Patients. Four healthy lactating women 8-26 weeks postpartum.
Intervention. All subjects received a single, oral, 100-mg dose of
nitrofurantoin macrocrystals with food. Serial serum and milk samples were
obtained and analyzed by high-performance liquid chromatography.
Measurements and Main Results. Milk pH, milk fat partitioning, and protein
binding in serum and milk were determined. Predicted milk:serum ratio (M:S)
was compared with the observed M:S. Nitrofurantoin M:S predicted was 0.28 ±
0.05, whereas M:S observed was 6.21 ± 2.71. Average milk concentration was
1.3 mg/L, and estimated suckling infant dosage was 0.2 mg/kg/day or 6% of
maternal dose (mg/kg).
Conclusions. Nitrofurantoin is actively transported into human milk,
achieving concentrations in milk greatly exceeding those in serum. Concern
is warranted for suckling infants younger than 1 month old, or for infants
with a high frequency of glucose-6-phosphate dehydrogenase deficiency or
sensitivity to nitrofurantoin. [Pharmacotherapy 21(6):669-675, 2001. © 2001
Pharmacotherapy Publications, Inc.]

Anna Swisher
LLL Leader
Austin, TX

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