Methotrexate Use in a Breastfeeding Patient with Rheumatoid Arthritis
| Autor: | Nadarajah T, Ito S, Thorne Jc, Moretti M |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Pregnancy business.industry Immunology Choriocarcinoma Breastfeeding Pharmacology medicine.disease Rheumatology Internal medicine Rheumatoid arthritis Immunology and Allergy Medicine Methotrexate business Adverse effect Breast feeding Postpartum period medicine.drug |
| Zdroj: | The Journal of Rheumatology. 41:2332-2332 |
| ISSN: | 1499-2752 0315-162X |
| Popis: | To the Editor: Methotrexate (MTX), a folic acid antagonist, is considered the first-line treatment in the management of rheumatoid arthritis (RA)1. As a result of embryotoxic and teratogenic effects, MTX is discontinued in women planning to conceive2,3,4. RA disease activity often decreases during pregnancy and increases after delivery5. Thus, women with RA are monitored closely following delivery. Breastfeeding may also pose challenges, attributable to the concern about drug exposure for the infant and potential drug-related adverse effects. The American Academy of Pediatrics and other reviews recommend the avoidance of MTX in breastfeeding women3,4,6. There is limited evidence of mammary excretion of MTX. One case report from 1972 describes MTX milk levels in a 25-year-old lactating mother with choriocarcinoma being treated with oral MTX at a dose of 22.5 mg per day7. Milk, blood, and urine samples were obtained at 2-h intervals on the first day of treatment and MTX levels were assessed using a bioassay … Address correspondence to Dr. T. Nadarajah, University of Toronto, Medicine, 500 University Ave., Suite 602, Toronto, Ontario M5G 1V7, Canada. E-mail: thanu.nadarajah{at}gmail.com |
| Databáze: | OpenAIRE |
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