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.
journal_name
Pharmacotherapyjournal_title
Pharmacotherapyauthors
Gerk PM,Kuhn RJ,Desai NS,McNamara PJdoi
10.1592/phco.21.7.669.34574subject
Has Abstractpub_date
2001-06-01 00:00:00pages
669-75issue
6eissn
0277-0008issn
1875-9114journal_volume
21pub_type
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