Nifedipine breastfeeding
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Nifedipine and Breastfeeding: Implications and Considerations
Introduction to Nifedipine and Breastfeeding
Nifedipine is a calcium channel blocker commonly used to manage hypertension. Its use during breastfeeding raises questions about its safety and the potential effects on both the nursing mother and the infant. This article synthesizes recent research findings on the impact of nifedipine on breastfeeding, focusing on its transfer to breast milk and the subsequent effects on infants.
Transfer of Nifedipine to Breast Milk
ABCG2 Polymorphism and Nifedipine Concentration
Research has shown that the transfer of nifedipine to breast milk can be influenced by genetic factors, specifically the ABCG2 c.421C>A polymorphism. In a study involving hypertensive breastfeeding women, it was found that those with the ABCG2 c.421C>A polymorphism had significantly higher concentrations of nifedipine in their breast milk compared to those without the polymorphism. Women with the 421 CA genotype had breast milk concentrations of nifedipine approximately three times higher than those with the 421 CC genotype. This suggests that genetic screening could be important for assessing the risk of nifedipine transfer to breast milk.
Effects on Infants
Calcium Channel Regulation in Newborns
Another study investigated the effects of nifedipine on newborn rats breastfed by mothers treated with the drug. The research focused on the regulation of calcium channels in the vas deferens of the newborns. It was found that nifedipine treatment during the middle period of lactation (9th to 16th day) led to a significant up-regulation of L-type calcium channels in the newborns. This up-regulation was temporary and reversible, with no persistent changes observed in the vas deferens of 60-day-old litters. Importantly, the study noted that there were no changes in body weight, vas deferens weight, or blood testosterone levels in the newborns, indicating that the overall physical development was not adversely affected.
Conclusion
The use of nifedipine during breastfeeding presents a complex scenario. Genetic factors, such as the ABCG2 c.421C>A polymorphism, can significantly influence the concentration of nifedipine in breast milk, potentially increasing the exposure of nursing infants to the drug. However, studies on animal models suggest that while there may be temporary changes in calcium channel regulation, these effects are reversible and do not appear to impact overall physical development. These findings underscore the importance of personalized medical advice and genetic screening for breastfeeding mothers undergoing nifedipine treatment to ensure the safety and well-being of both mother and child.
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