Excretion of sotalol in breast milk.

Hackett, L.P.; Wojnar-Horton, R. E.; Dusci, L.J.; Ilett, K. F.; Roberts, M. J.

doi:10.1111/j.1365-2125.1990.tb03635.x

Cited by 39 publications

(14 citation statements)

References 3 publications

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“…Control of the arrhythmia was achieved in 10/14 foetuses. In foetuses without hydrops, sotalol given orally to the mothers has been demonstrated to pass the placenta resulting in a foetal concentration corresponding to 50-100% of the maternal concentration (11,12). The present study also confirms that lack of adequate response of foetal SVT to digoxin therapy alone is most frequently related to the presence of foetal hydrops.…”

Section: Discussionsupporting

confidence: 79%

“…Orally administered sotalol is virtually completely absorbed and does not undergo firstpass metabolism in the liver, resulting in an absolute bioavailability of 90-100% (1). It is hydrophilic, passes the placental barrier freely and the relation between maternal and foetal sotalol concentrations has been shown to be approximately 1.0:1.1 (11). Sotalol can consequently be expected to have a place in the treatment of foetal SVT.…”

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confidence: 99%

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Foetal supraventricular tachycardia treated with sotalol

Sonesson¹,

Jc²,

Wesslen-Eriksson³

et al. 1998

SPAE

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This retrospective study (1991-95) presents our experience with sotalol in the treatment of 14 foetuses with supraventricular tachycardia (SVT). SVT was diagnosed in a structurally normal heart at a gestational age of 24-35 (median 28) weeks. In eight foetuses, hydrops was evident at presentation. In all patients pharmacological conversion with digoxin was tried before sotalol treatment was started. Sotalol was given orally to the mothers in a dose of 80-160 mg x 2. Cardioversion was obtained in 10 foetuses. In seven of these patients re-entry tachycardia and in five pre-excitation could be documented after birth. In two foetuses not responding to sotalol a long RP tachycardia was demonstrated; even when using digoxin, sotalol, flecainide and/or propafenone in different combinations after birth complete suppression of the arrhythmia was not obtained. Two severely hydropic foetuses died 1 and 10 d, respectively, after starting with sotalol. The 12 surviving infants were doing well except for one infant, with a cerebral lesion probably related to the arrhythmia. These findings demonstrate that sotalol can be useful in the treatment of foetal SVT.

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Section: Discussionsupporting

confidence: 79%

mentioning

confidence: 99%

Foetal supraventricular tachycardia treated with sotalol

Sonesson¹,

Jc²,

Wesslen-Eriksson³

et al. 1998

SPAE

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“…This was performed, as previously, a Milk:plasma ratios were reported at 2.86 and 0.36 (Atkinson et al, 1990a), and 0.99 (Ette et al, 1987). Average = 1.40. b Milk:plasma ratios were reported from 2.43-5.64 (Hackett et al, 1990). Also reported as 3.16 (Wagner et al, 1990).…”

Section: Resultsmentioning

confidence: 99%

Prospective evaluation of a model for the prediction of milk:plasma drug concentrations from physicochemical characteristics.

Begg¹,

Atkinson²,

Duffull³

1992

Brit J Clinical Pharma

100

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There was no significant bias in the predictions. 6 The model was refined by multiple linear regression analysis utilising the observed M/P ratios for the 10 basic drugs in addition to those of the original drugs. The revised equation resulted in an improvement in the explained variance. 7 Protein binding was the most important single predictor. 8 The results confirm that M/P ratios for basic drugs can be predicted accurately from their physicochemical characteristics.

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“…Close fetal monitoring is essential. Sotalol is readily excreted in breast milk and some data have suggested that the infant may ingest up to 20% of the maternal dose, 54 although breastfeeding is considered safe if the child is regularly assessed for the signs of toxicity.…”

Section: Cordina and Mcguire Arrhythmias In Pregnancymentioning

confidence: 99%

Maternal cardiac arrhythmias during pregnancy and lactation

Cordina

McGuire

2010

Obstet Med

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Arrhythmias occurring during pregnancy can cause significant symptoms and even death in mother and fetus. The management of these arrhythmias is complicated by the need to avoid harm to the fetus and neonate. It is useful to classify patients with arrhythmias into those with and without structural heart disease. Those with a primary electrical problem, but an otherwise normal heart, often tolerate rapid heart rates without compromise whereas patients with problems such as rheumatic heart disease, congenital heart disease or cardiomyopathy may quickly decompensate during an arrhythmia.

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Excretion of sotalol in breast milk.

Cited by 39 publications

References 3 publications

Foetal supraventricular tachycardia treated with sotalol

Foetal supraventricular tachycardia treated with sotalol

Prospective evaluation of a model for the prediction of milk:plasma drug concentrations from physicochemical characteristics.

Maternal cardiac arrhythmias during pregnancy and lactation

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