Breastfed infants exposed to lamotrigine faced a low risk of toxic effects

IF 2.1 4区 医学 Q1 PEDIATRICS Acta Paediatrica Pub Date : 2024-09-20 DOI:10.1111/apa.17432
Ingrid Alvarez, Katarina Tötterman, Emma Honkaniemi, Ihsan Sarman, Karin Bäck, Lisa Forsberg, Essi Whaites Heinonen, Jenny Svedenkrans
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Abstract

Aim

We aimed to investigate plasma lamotrigine concentrations and clinical effects in infants exposed to lamotrigine through breastfeeding.

Methods

This was a retrospective study of mother–infant dyads in a clinical follow-up programme in Stockholm, Sweden. Data were collected from medical records.

Results

We included 47 breastfed infants, born from 2011 to 2021, with a median gestational age of 39 + 6 weeks/days and a median birth weight of 3420 g. The median lamotrigine concentration in the infants' plasma was 2.5 (range 2.5–14.0) μmol/L. These concentrations correlated significantly with both the maternal plasma concentrations and the maternal doses (R = 0.79, p < 0.001 versus R = 0.54, p < 0.001). During the follow up, lamotrigine concentrations within the reference range for epilepsy treatment were detected in six (14%) infants and one had clinical symptoms that were probably related to lamotrigine exposure. Liver transaminases were elevated in three of 21 infants. All infants whose mothers had a dose of 150 mg or less had undetectable plasma concentrations and no symptoms during follow up.

Conclusion

Infants exposed to lamotrigine through breastfeeding had a low risk of toxic effects. All infants whose mothers had low lamotrigine doses had unmeasurable plasma concentrations and no symptoms of lamotrigine exposure. These low-risk infants might be offered a simplified follow up.

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母乳喂养的婴儿接触拉莫三嗪后出现毒性反应的风险较低
我们的目的是研究通过母乳喂养接触拉莫三嗪的婴儿的血浆拉莫三嗪浓度和临床影响。
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来源期刊
Acta Paediatrica
Acta Paediatrica 医学-小儿科
CiteScore
6.50
自引率
5.30%
发文量
384
审稿时长
2-4 weeks
期刊介绍: Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including: neonatal medicine developmental medicine adolescent medicine child health and environment psychosomatic pediatrics child health in developing countries
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