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Pharmacotherapy. 2001 Jun;21(6):669-75.

Active transport of nitrofurantoin into human milk.

Author information

1
Division of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington 40536-0082, USA.

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.

PMID:
11401180
[Indexed for MEDLINE]

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