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Pharmacological Treatment of Musculoskeletal Conditions During Pregnancy and Lactation

  • Chapter
Musculoskeletal Health in Pregnancy and Postpartum

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Abstract

Pain management is an important aspect of good prenatal and postnatal care. Many women are unnecessarily advised to stop taking needed medications when pregnant or to stop breastfeeding due to unknown risks to their developing fetus or infant. Significant congenital malformations are uncommon, but do occur in approximately 3 % of newborns in the general population (Pediatrics 117(1):168–83, 2006). Of these, an environmental link may contribute to approximately 10 % of the overall frequency of birth defects, which include pharmacologic exposures (UpToDate. Waltham; 2013). Although some medications such as isotretinoin, thalidomide, and mycophenolic acid are contraindicated in pregnancy, the fear associated with these major teratogens have resulted in denial of therapeutically appropriate medications to pregnant women (Lancet 2(8348):513, 1983; Acta Ophthalmol 71(2):238–45, 1993; Am J Med Genet A 158A(3):588–96, 2012). Information is growing which can help providers make informed decisions on the risk versus benefits of pharmacotherapeutic management during pregnancy and postpartum. This chapter is a general overview of the safety of medications used to manage musculoskeletal pain and injuries during pregnancy and postpartum. This is not intended to be an all-inclusive listing of adverse events reported during pregnancy. The reader is referred to the primary literature when that level of understanding is needed.

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References

  1. Rathmell JP, Viscomi CM, Ashburn MA. Management of nonobstetric pain during pregnancy and lactation. Anesth Analg. 1997;85(5):1074–87.

    Article  CAS  PubMed  Google Scholar 

  2. Ostrer H. Genetic and environmental causes of birth defects. In: Post TW, editor. UpToDate. Waltham; 2013. Topic 6829 Version 11.0. Accessed 24 Feb 2014.

    Google Scholar 

  3. Hébert MF, Easterling TR, Kirby B, Carr DB, Buchanan ML, Rutherford T, et al. Effects of pregnancy on CYP3A and P-glycoprotein activities as measured by disposition of midazolam and digoxin: a University of Washington specialized center of research study. Clin Pharmacol Ther. 2008;84(2):248–53.

    Article  PubMed  Google Scholar 

  4. Zhou L, Naraharisetti SB, Liu L, Wang H, Lin YS, Isoherranen N, et al. Contributions of human cytochrome P450 enzymes to glyburide metabolism. Biopharm Drug Dispos. 2010;31(4):228–42.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Buchanan ML, Easterling TR, Carr DB, Shen DD, Risler LJ, Nelson WL, et al. Clonidine pharmacokinetics in pregnancy. Drug Metab Dispos. 2009;37(4):702–5.

    Article  CAS  PubMed  Google Scholar 

  6. de Haan GJ, Edelbroek P, Segers J, Engelsman M, Lindhout D, Devile-Notschaele M, et al. Gestation-induced changes in lamotrigine pharmacokinetics: a monotherapy study. Neurology. 2004;63(3):571–3.

    Article  PubMed  Google Scholar 

  7. Andrew MA, Easterling TR, Carr DB, Shen D, Buchanan ML, Rutherford T, et al. Amoxicillin pharmacokinetics in pregnant women: modeling and simulations of dosage strategies. Clin Pharmacol Ther. 2007;81(4):547–56.

    Article  CAS  PubMed  Google Scholar 

  8. Zheng S, Easterling TR, Umans JG, Miodovnik M, Calamia JC, Thummel KE, et al. Pharmacokinetics of tacrolimus during pregnancy. Ther Drug Monit. 2012;34(6):660–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Zheng S, Easterling TR, Hays K, Umans JG, Miodovnik M, Clark S, et al. Tacrolimus placental transfer at delivery and neonatal exposure through breast milk. Br J Clin Pharmacol. 2013;76(6):988–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Black RA, Hill DA. Over-the-counter medications in pregnancy. Am Fam Physician. 2003;67(12):2517–24.

    PubMed  Google Scholar 

  11. Cleves MA, Savell Jr VH, Raj S, Zhao W, Correa A, Werler MM, et al. Maternal use of acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), and muscular ventricular septal defects. Birth Defects Res A Clin Mol Teratol. 2004;70(3):107–13.

    Article  CAS  PubMed  Google Scholar 

  12. Persky V, Piorkowski J, Hernandez E, Chavez N, Wagner-Cassanova C, Vergara C, et al. Prenatal exposure to acetaminophen and respiratory symptoms in the first year of life. Ann Allergy Asthma Immunol. 2008;101(3):271–8.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Li DK, Liu L, Odouli R. Exposure to non-steroidal anti-inflammatory drugs during pregnancy and risk of miscarriage: population based cohort study. BMJ. 2003;327(7411):368.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Nielsen GL, Skriver MV, Pedersen L, Sorensen HT. Danish group reanalyses miscarriage in NSAID users. BMJ. 2004;328(7431):109.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Nielsen GL, Sorensen HT, Larsen H, Pedersen L. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal anti-inflammatory drugs: population based observational study and case-control study. BMJ. 2001;322(7281):266–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Kallen BA, Otterblad Olausson P. Maternal drug use in early pregnancy and infant cardiovascular defect. Reprod Toxicol. 2003;17(3):255–61.

    Article  CAS  PubMed  Google Scholar 

  17. Torfs CP, Katz EA, Bateson TF, Lam PK, Curry CJ. Maternal medications and environmental exposures as risk factors for gastroschisis. Teratology. 1996;54(2):84–92.

    Article  CAS  PubMed  Google Scholar 

  18. Werler MM, Mitchell AA, Shapiro S. First trimester maternal medication use in relation to gastroschisis. Teratology. 1992;45(4):361–7.

    Article  CAS  PubMed  Google Scholar 

  19. Ofori B, Oraichi D, Blais L, Rey E, Berard A. Risk of congenital anomalies in pregnant users of non-steroidal anti-inflammatory drugs: a nested case-control study. Birth Defects Res B Dev Reprod Toxicol. 2006;77(4):268–79.

    Article  CAS  PubMed  Google Scholar 

  20. Momma K, Takeuchi H. Constriction of fetal ductus arteriosus by nonsteroidal antiinflammatory drugs. Adv Prostaglandin Thromboxane Leukot Res. 1983;12:499–504.

    CAS  PubMed  Google Scholar 

  21. Leslie GI, Gallery ED, Arnold JD, Ross MR, Gyory AZ. Neonatal outcome in a randomized, controlled trial of low-dose aspirin in high-risk pregnancies. J Paediatr Child Health. 1995;31(6):549–52.

    Article  CAS  PubMed  Google Scholar 

  22. Low dose aspirin in pregnancy and early childhood development: follow up of the collaborative low dose aspirin study in pregnancy. CLASP collaborative group. Br J Obstet Gynaecol. 1995;102(11):861–8.

    Google Scholar 

  23. Lewis RB, Schulman JD. Influence of acetylsalicylic acid, an inhibitor of prostaglandin synthesis, on the duration of human gestation and labour. Lancet. 1973;2(7839):1159–61.

    Article  CAS  PubMed  Google Scholar 

  24. American Medical Association Department of Drugs. AMA drug evaluations. 6th ed. Chicago: American Medical Association; 1986.

    Google Scholar 

  25. Rumack CM, Guggenheim MA, Rumack BH, Peterson RG, Johnson ML, Braithwaite WR. Neonatal intracranial hemorrhage and maternal use of aspirin. Obstet Gynecol. 1981;58(5 Suppl):52S–6.

    CAS  PubMed  Google Scholar 

  26. Broussard CS, Rasmussen SA, Reefhuis J, Friedman JM, Jann MW, Riehle-Colarusso T, et al. Maternal treatment with opioid analgesics and risk for birth defects. Am J Obstet Gynecol. 2011;204(4):314.e1–11.

    Article  PubMed  Google Scholar 

  27. Sardemann H, Madsen KS, Friis-Hansen B. Follow-up of children of drug-addicted mothers. Arch Dis Child. 1976;51(2):131–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Levy M, Spino M. Neonatal withdrawal syndrome: associated drugs and pharmacologic management. Pharmacotherapy. 1993;13(3):202–11.

    CAS  PubMed  Google Scholar 

  29. Janson LM. Neonatal abstinence syndrome. In: Rose B, editor. UpToDate. Waltham; 2014. Topic 5016 Version 22.0. Accessed 24 Feb 2014.

    Google Scholar 

  30. Kanto JH. Use of benzodiazepines during pregnancy, labour and lactation, with particular reference to pharmacokinetic considerations. Drugs. 1982;23(5):354–80.

    Article  CAS  PubMed  Google Scholar 

  31. Cree JE, Meyer J, Hailey DM. Diazepam in labour: its metabolism and effect on the clinical condition and thermogenesis of the newborn. Br Med J. 1973;4(5887):251–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Gillberg C. “Floppy infant syndrome” and maternal diazepam. Lancet. 1977;2(8031):244.

    Article  CAS  PubMed  Google Scholar 

  33. Sachs HC. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013;132(3):e796–809.

    Article  PubMed  Google Scholar 

  34. Kanto J, Erkkola R, Sellman R. Accumulation of diazepam and N-demethyldiazepam in the fetal blood during the labour. Ann Clin Res. 1973;5(6):375–9.

    CAS  PubMed  Google Scholar 

  35. Jorgensen NP, Thurmann-Nielsen E, Walstad RA. Pharmacokinetics and distribution of diazepam and oxazepam in early pregnancy. Acta Obstet Gynecol Scand. 1988;67(6):493–7.

    Article  CAS  PubMed  Google Scholar 

  36. McBride RJ, Dundee JW, Moore J, Toner W, Howard PJ. A study of the plasma concentrations of lorazepam in mother and neonate. Br J Anaesth. 1979;51(10):971–8.

    Article  CAS  PubMed  Google Scholar 

  37. Kanto J, Aaltonen L, Liukko P, Maenpaa K. Transfer of lorazepam and its conjugate across the human placenta. Acta Pharmacol Toxicol. 1980;47(2):130–4.

    Article  CAS  Google Scholar 

  38. Nordeng H, Zahlsen K, Spigset O. Transfer of carisoprodol to breast milk. Ther Drug Monit. 2001;23(3):298–300.

    Article  CAS  PubMed  Google Scholar 

  39. Heinonen OP, Slone D, Shapiro S. Birth defects and drugs in pregnancy. Littleton: Publishing Sciences Group; 1977. p. 357–65.

    Google Scholar 

  40. Briggs GG, Ambrose PJ, Nageotte MP, Padilla G. High-dose carisoprodol during pregnancy and lactation. Ann Pharmacother. 2008;42(6):898–901.

    Article  PubMed  Google Scholar 

  41. Milkovich L, van den Berg BJ. Effects of prenatal meprobamate and chlordiazepoxide hydrochloride on human embryonic and fetal development. N Engl J Med. 1974;291(24):1268–71.

    Article  CAS  PubMed  Google Scholar 

  42. Hartz SC, Heinonen OP, Shapiro S, Siskind V, Slone D. Antenatal exposure to meprobamate and chlordiazepoxide in relation to malformations, mental development, and childhood mortality. N Engl J Med. 1975;292(14):726–8.

    Article  CAS  PubMed  Google Scholar 

  43. Flannery DB. Syndrome of imperforate oropharynx with costovertebral and auricular anomalies. Am J Med Genet. 1989;32(2):189–91.

    Article  CAS  PubMed  Google Scholar 

  44. Rosa F. Personal communication. 1993. Cited in: Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 345, 1175.

    Google Scholar 

  45. Prednisone. In: Reprotox [database on the Internet]. Ann Arbor: Truven Health Analytics; 2014. www.micromedexsolutions.com. Subscription required to view. Accessed 24 Feb 2014.

  46. Cote CJ, Meuwissen HJ, Pickering RJ. Effects on the neonate of prednisone and azathioprine administered to the mother during pregnancy. J Pediatr. 1974;85(3):324–8.

    Article  CAS  PubMed  Google Scholar 

  47. Saulnier PJ, Piguel X, Perault-Pochat MC, Csizmadia-Bremaud C, Saulnier JP. Hypoglycaemic seizure and neonatal acute adrenal insufficiency after maternal exposure to prednisone during pregnancy: a case report. Eur J Pediatr. 2010;169(6):763–5.

    Article  PubMed  Google Scholar 

  48. RAYOS (prednisone) oral delayed-release tablets. Horizon Pharma USA Inc; 2012. Package insert.

    Google Scholar 

  49. Higuchi M, Takeuchi S. [Studies on neurobehavioral response (Scanlon test) in newborns after epidural anesthesia with various anesthetic agents for cesarean section]. Nihon Sanka Fujinka Gakkai Zasshi. 1982;34(12):2143–8.

    CAS  PubMed  Google Scholar 

  50. Ransjo-Arvidson AB, Matthiesen AS, Lilja G, Nissen E, Widstrom AM, Uvnas-Moberg K. Maternal analgesia during labor disturbs newborn behavior: effects on breastfeeding, temperature, and crying. Birth. 2001;28(1):5–12.

    Article  CAS  PubMed  Google Scholar 

  51. Bupivacaine. In: DRUGDEX System [database on the internet]. Ann Arbor: Truven Health Analytics; 2014. www.micromedexsolutions.com. Subscription required to view. Accessed 24 Feb 2014.

  52. Abouleish E. Foetal bradycardia during caudal analgesia: a discussion of possible causative factors. Br J Anaesth. 1976;48(5):481–4.

    Article  CAS  PubMed  Google Scholar 

  53. Johnson RF, Cahana A, Olenick M, Herman N, Paschall RL, Minzter B, et al. A comparison of the placental transfer of ropivacaine versus bupivacaine. Anesth Analg. 1999;89(3):703–8.

    Article  CAS  PubMed  Google Scholar 

  54. Rodesch F, Camus M, Ermans AM, Dodion J, Delange F. Adverse effect of amniofetography on fetal thyroid function. Am J Obstet Gynecol. 1976;126(6):723–6.

    Article  CAS  PubMed  Google Scholar 

  55. Atwell TD, Lteif AN, Brown DL, McCann M, Townsend JE, Leroy AJ. Neonatal thyroid function after administration of IV iodinated contrast agent to 21 pregnant patients. AJR Am J Roentgenol. 2008;191(1):268–71.

    Article  PubMed  Google Scholar 

  56. Chen MM, Coakley FV, Kaimal A, Laros Jr RK. Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. Obstet Gynecol. 2008;112(2 Pt 1):333–40.

    Article  PubMed  Google Scholar 

  57. Kanal E, Barkovich AJ, Bell C, Borgstede JP, Bradley Jr WG, Froelich JW, et al. ACR guidance document for safe MR practices: 2007. AJR Am J Roentgenol. 2007;188(6):1447–74.

    Article  PubMed  Google Scholar 

  58. Marcos HB, Semelka RC, Worawattanakul S. Normal placenta: gadolinium-enhanced dynamic MR imaging. Radiology. 1997;205(2):493–6.

    Article  CAS  PubMed  Google Scholar 

  59. Barkhof F, Heijboer RJ, Algra PR. Inadvertent i.v. administration of gadopentetate dimeglumine during early pregnancy. AJR Am J Roentgenol. 1992;158(5):1171.

    Article  CAS  PubMed  Google Scholar 

  60. De Santis M, Straface G, Cavaliere AF, Carducci B, Caruso A. Gadolinium periconceptional exposure: pregnancy and neonatal outcome. Acta Obstet Gynecol Scand. 2007;86(1):99–101.

    Article  PubMed  Google Scholar 

  61. Hale TW. Medications and mothers’ milk 2012. Fifteenthth ed. Hale Publishing: Amarillo; 2012.

    Google Scholar 

  62. TYLENOL(R) oral, acetaminophen oral. Skillman: McNeil Consumer Healthcare; 2012. Package insert.

    Google Scholar 

  63. Matheson I, Lunde PK, Notarianni L. Infant rash caused by paracetamol in breast milk? Pediatrics. 1985;76(4):651–2.

    Article  CAS  PubMed  Google Scholar 

  64. Walter K, Dilger C. Ibuprofen in human milk. Br J Clin Pharmacol. 1997;44(2):211–2.

    Article  CAS  PubMed  Google Scholar 

  65. Gardiner SJ, Doogue MP, Zhang M, Begg EJ. Quantification of infant exposure to celecoxib through breast milk. Br J Clin Pharmacol. 2006;61(1):101–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Hale TW, McDonald R, Boger J. Transfer of celecoxib into human milk. J Hum Lact. 2004;20(4):397–403.

    Article  PubMed  Google Scholar 

  67. Jamali F, Stevens DR. Naproxen excretion in milk and its uptake by the infant. Drug Intell Clin Pharm. 1983;17(12):910–1.

    CAS  PubMed  Google Scholar 

  68. Putter J, Satravaha P, Stockhausen H. [Quantitative analysis of the main metabolites of acetylsalicylic acid. Comparative analysis in the blood and milk of lactating women (author’s transl)]. Z Geburtshilfe Perinatol. 1974;178(2):135–8.

    CAS  PubMed  Google Scholar 

  69. Bailey DN, Weibert RT, Naylor AJ, Shaw RF. A study of salicylate and caffeine excretion in the breast milk of two nursing mothers. J Anal Toxicol. 1982;6(2):64–8.

    Article  CAS  PubMed  Google Scholar 

  70. Clark JH, Wilson WG. A 16-day-old breast-fed infant with metabolic acidosis caused by salicylate. Clin Pediatr. 1981;20(1):53–4.

    Article  CAS  Google Scholar 

  71. Terragna A, Spirito L. [Thrombocytopenic purpura in an infant after administration of acetylsalicylic acid to the wet-nurse]. Minerva Pediatr. 1967;19(13):613–6.

    CAS  PubMed  Google Scholar 

  72. Harley JD, Robin H. “Late” neonatal jaundice in infants with glucose-6-phosphate dehydrogenase-deficient erythrocytes. Australas Ann Med. 1962;11:148–55.

    Article  CAS  PubMed  Google Scholar 

  73. Bennett PN, Jensen AA. Drugs and human lactation: a comprehensive guide to the content and consequences of drugs, micronutrients, radiopharmaceuticals, and environmental and occupational chemicals in human milk. 2nd ed. Amsterdam: Elsevier; 1996. ix, 712 p.

    Google Scholar 

  74. Anderson PO, Sauberan JB, Lane JR, Rossi SS. Hydrocodone excretion into breast milk: the first two reported cases. Breastfeed Med. 2007;2(1):10–4.

    Article  PubMed  Google Scholar 

  75. Sauberan JB, Anderson PO, Lane JR, Rafie S, Nguyen N, Rossi SS, et al. Breast milk hydrocodone and hydromorphone levels in mothers using hydrocodone for postpartum pain. Obstet Gynecol. 2011;117(3):611–7.

    Article  CAS  PubMed  Google Scholar 

  76. Marx CM, Pucino F, Carlson JD, et al. Oxycodone excretion in human milk in the puerperium. Drug Intell Clin Pharm. 1986;20:474; Abstract.

    Google Scholar 

  77. Findlay JW, DeAngelis RL, Kearney MF, Welch RM, Findlay JM. Analgesic drugs in breast milk and plasma. Clin Pharmacol Ther. 1981;29(5):625–33.

    Article  CAS  PubMed  Google Scholar 

  78. Naumburg EG, Meny RG, Findlay J, et al. Codeine and morphine levels in breast milk and neonatal plasma. Pediatr Res. 1987;21(4, pt 2):240A; Abstract.

    Article  Google Scholar 

  79. Edwards JE, Rudy AC, Wermeling DP, Desai N, McNamara PJ. Hydromorphone transfer into breast milk after intranasal administration. Pharmacotherapy. 2003;23(2):153–8.

    Article  CAS  PubMed  Google Scholar 

  80. Robieux I, Koren G, Vandenbergh H, Schneiderman J. Morphine excretion in breast milk and resultant exposure of a nursing infant. J Toxicol Clin Toxicol. 1990;28(3):365–70.

    Article  CAS  PubMed  Google Scholar 

  81. Madadi P, Ross CJ, Hayden MR, Carleton BC, Gaedigk A, Leeder JS, et al. Pharmacogenetics of neonatal opioid toxicity following maternal use of codeine during breastfeeding: a case-control study. Clin Pharmacol Ther. 2009;85(1):31–5.

    Article  CAS  PubMed  Google Scholar 

  82. Koren G, Cairns J, Chitayat D, Gaedigk A, Leeder SJ. Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet. 2006;368(9536):704.

    Article  PubMed  Google Scholar 

  83. Meineke I, Freudenthaler S, Hofmann U, Schaeffeler E, Mikus G, Schwab M, et al. Pharmacokinetic modelling of morphine, morphine-3-glucuronide and morphine-6-glucuronide in plasma and cerebrospinal fluid of neurosurgical patients after short-term infusion of morphine. Br J Clin Pharmacol. 2002;54(6):592–603.

    CAS  PubMed  Google Scholar 

  84. Chau N, Elliot DJ, Lewis BC, Burns K, Johnston MR, Mackenzie PI, et al. Morphine glucuronidation and glucosidation represent complementary metabolic pathways which are both catalyzed by UDP-glucuronosyltransferase 2B7: kinetic, inhibition and molecular modelling studies. J Pharmacol Exp Ther. 2014;349(1):126–37.

    Article  PubMed  Google Scholar 

  85. Kelly LE, Chaudhry SA, Rieder MJ, ‘t Jong G, Moretti ME, Lausman A, et al. A clinical tool for reducing central nervous system depression among neonates exposed to codeine through breast milk. PLoS One. 2013;8(7):e70073.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Cascorbi I. Pharmacogenetics of cytochrome p4502D6: genetic background and clinical implication. Eur J Clin Invest. 2003;33 Suppl 2:17–22.

    Article  CAS  PubMed  Google Scholar 

  87. Madadi P, Avard D, Koren G. Pharmacogenetics of opioids for the treatment of acute maternal pain during pregnancy and lactation. Curr Drug Metab. 2012;13(6):721–7.

    Article  CAS  PubMed  Google Scholar 

  88. Benedetti MS, Whomsley R, Canning M. Drug metabolism in the paediatric population and in the elderly. Drug Discov Today. 2007;12(15–16):599–610.

    Article  CAS  PubMed  Google Scholar 

  89. Lam J, Kelly L, Ciszkowski C, Landsmeer ML, Nauta M, Carleton BC, et al. Central nervous system depression of neonates breastfed by mothers receiving oxycodone for postpartum analgesia. J Pediatr. 2012;160(1):33–7.e2.

    Article  CAS  PubMed  Google Scholar 

  90. Seaton S, Reeves M, McLean S. Oxycodone as a component of multimodal analgesia for lactating mothers after Caesarean section: relationships between maternal plasma, breast milk and neonatal plasma levels. Aust N Z J Obstet Gynaecol. 2007;47(3):181–5.

    Article  PubMed  Google Scholar 

  91. Whitelaw AG, Cummings AJ, McFadyen IR. Effect of maternal lorazepam on the neonate. Br Med J (Clin Res Ed). 1981;282(6270):1106–8.

    Article  CAS  PubMed  Google Scholar 

  92. Kelly LE, Poon S, Madadi P, Koren G. Neonatal benzodiazepines exposure during breastfeeding. J Pediatr. 2012;161(3):448–51.

    Article  CAS  PubMed  Google Scholar 

  93. Erkkola R, Kanto J. Diazepam and breast-feeding. Lancet. 1972;1(7762):1235–6.

    Article  CAS  PubMed  Google Scholar 

  94. Wesson DR, Camber S, Harkey M, Smith DE. Diazepam and desmethyldiazepam in breast milk. J Psychoactive Drugs. 1985;17(1):55–6.

    Article  CAS  PubMed  Google Scholar 

  95. Patrick MJ, Tilstone WJ, Reavey P. Diazepam and breast-feeding. Lancet. 1972;1(7749):542–3.

    Article  CAS  PubMed  Google Scholar 

  96. Chaves RG, Lamounier JA, Cesar CC. Association between duration of breastfeeding and drug therapy. Asian Pac J Trop Dis. 2011;1:216–21.

    Article  Google Scholar 

  97. Lorazepam oral tablets. Corona: Watson Laboratories; 2008. Package insert.

    Google Scholar 

  98. Katz FH, Duncan BR. Letter: entry of prednisone into human milk. N Engl J Med. 1975;293(22):1154.

    Article  CAS  PubMed  Google Scholar 

  99. Sagraves R, Kaiser D, Sharpe GL. Prednisone and prednisolone concentrations in the milk of a lactating mother. Drug Intell Clin Pharm. 1981;15:484; Abstract.

    Google Scholar 

  100. Berlin Jr CM, Kaiser DG, Demers L. Excretion of prednisone and prednisolone in human milk. Pharmacologist. 1979;21:264; Abstract.

    Google Scholar 

  101. Ost L, Wettrell G, Bjorkhem I, Rane A. Prednisolone excretion in human milk. J Pediatr. 1985;106(6):1008–11.

    Article  CAS  PubMed  Google Scholar 

  102. Schaefer C. Drugs during pregnancy and lactation: handbook of prescription drugs and comparative risk assessment: with updated information on recreational drugs. 1st ed. Amsterdam: Elsevier; 2001. xi, 368 p.

    Google Scholar 

  103. Anderson PO. Corticosteroid use by breast-feeding mothers. Clin Pharm. 1987;6(6):445.

    CAS  PubMed  Google Scholar 

  104. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013;19(4):248–50.

    Article  PubMed  Google Scholar 

  105. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012;20(1):32–4.

    PubMed  Google Scholar 

  106. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008;121(1):e92–100.

    Article  PubMed  Google Scholar 

  107. Giuliani M, Grossi GB, Pileri M, Lajolo C, Casparrini G. Could local anesthesia while breast-feeding be harmful to infants? J Pediatr Gastroenterol Nutr. 2001;32(2):142–4.

    Article  CAS  PubMed  Google Scholar 

  108. Baker PA, Schroeder D. Interpleural bupivacaine for postoperative pain during lactation. Anesth Analg. 1989;69(3):400–2.

    Article  CAS  PubMed  Google Scholar 

  109. Ortega D, Viviand X, Lorec AM, Gamerre M, Martin C, Bruguerolle B. Excretion of lidocaine and bupivacaine in breast milk following epidural anesthesia for cesarean delivery. Acta Anaesthesiol Scand. 1999;43(4):394–7.

    Article  CAS  PubMed  Google Scholar 

  110. Matsota PK, Markantonis SL, Fousteri MZ, Pandazi AK, Manikis DE, Christodoulopoulou TC, et al. Excretion of ropivacaine in breast milk during patient-controlled epidural analgesia after cesarean delivery. Reg Anesth Pain Med. 2009;34(2):126–9.

    Article  CAS  PubMed  Google Scholar 

  111. Goodman LS, Gilman A, Brunton LL. Goodman & Gilman’s manual of pharmacology and therapeutics. New York: McGraw-Hill Medical; 2008. ix, 1219 p.

    Google Scholar 

  112. American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108(3):776–89.

    Article  Google Scholar 

  113. World Health Organization, UNICEF. Breastfeeding and maternal medication. Recommendations for drugs in the eleventh WHO model list of essential drugs. Geneva: WHO, UNICEF; 2002.

    Google Scholar 

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Authors and Affiliations

  1. Department of Pharmacy, University of Washington Medical Center, 1959 NE Pacific St., 356015, Seattle, WA, 98195-6015, USA

    Joong Kim PharmD

  2. Department of Pharmacy, University of Washington, 1959 NE Pacific St., H-375 Health Sciences Center, 357630, Seattle, WA, 98195-7630, USA

    Mary F. Hébert PharmD, FCCP

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Correspondence to Mary F. Hébert PharmD, FCCP .

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  1. Department of Obstetrics & Gynecology, Loyola University, Maywood, Illinois, USA

    Colleen M. Fitzgerald

  2. Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas, USA

    Neil A. Segal

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Kim, J., Hébert, M.F. (2015). Pharmacological Treatment of Musculoskeletal Conditions During Pregnancy and Lactation. In: Fitzgerald, C., Segal, N. (eds) Musculoskeletal Health in Pregnancy and Postpartum. Springer, Cham. https://doi.org/10.1007/978-3-319-14319-4_14

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  • DOI: https://doi.org/10.1007/978-3-319-14319-4_14

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14318-7

  • Online ISBN: 978-3-319-14319-4

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