Nifedipine for breastfeeding
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Nifedipine and Breastfeeding: Implications and Considerations
Introduction to Nifedipine Use During 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 current research findings on the transfer of nifedipine to breast milk and its impact on infants.
Nifedipine Transfer to Breast Milk
ABCG2 Polymorphism and Nifedipine Concentration
Research indicates that the transfer of nifedipine to breast milk can be influenced by genetic factors, specifically the ABCG2 c.421C>A polymorphism. A study involving hypertensive breastfeeding women treated with nifedipine 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 heterozygous 421 CA genotype had breast milk concentrations 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 explored the effects of nifedipine on calcium channel regulation in newborn rats breastfed by mothers treated with the drug. The findings showed that nifedipine treatment during the middle period of lactation (9th to 16th day) led to a temporary up-regulation of L-type calcium channels in the vas deferens of the offspring. This up-regulation was characterized by a 35% increase in maximal contractile responses and a 55% increase in calcium channel density, although these changes were not persistent and returned to control values by the 60th day . Importantly, no significant changes were observed in body weight, vas deferens weight, or blood testosterone levels of the newborns, indicating that the effects were specific to calcium channel regulation and were reversible.
Conclusion
The use of nifedipine during breastfeeding can lead to its transfer to breast milk, with higher concentrations observed in women with the ABCG2 c.421C>A polymorphism. While the drug can cause temporary changes in calcium channel regulation in infants, these effects are reversible and do not appear to impact overall growth or development. These findings highlight the importance of genetic screening and careful monitoring when prescribing nifedipine to breastfeeding mothers.
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