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What is known and objective: Statins are associated with improved pregnancy outcomes in patients with preeclamptic antiphospholipid syndrome (APS) and intrauterine foetal death. Several studies showed that statins are not teratogenic. However, data characterizing placental transfer and excretion of pravastatin into breast milk are limited. Case summary: We experienced two patients diagnosed with APS received 10 mg of pravastatin from the first trimester until delivery to prevent pre‐eclampsia. Pravastatin concentrations in maternal serum, infant serum and cord blood were evaluated. The estimated maternal‐foetal transfer ratios of pravastatin in the two patients were 25.5% and 23.8% respectively. Pravastatin was eliminated from neonatal serum within 2 days. Both infants developed normally with no drug‐related adverse effects. Pravastatin was not detected in either patient's breast milk at 3 days after the last dose. What is new and conclusion: The infants delivered from the mothers who were treated with pravastatin during pregnancy had no apparent adverse effects. [ABSTRACT FROM AUTHOR]

Safety information on diazoxide for pregnant and lactating women with hypoglycemia is limited. In this case report, we assessed diazoxide concentrations in maternal and infant blood, cord blood, and breast milk. We described a 30-year-old pregnant woman diagnosed with hypoglycemia due to nesidioblastosis at 4 months of age. Before becoming pregnant, she was treated with oral diazoxide (75–375 mg). All medications were discontinued after she was discovered to be pregnant. During gestational week 25, diazoxide treatment was resumed at 150–175 mg daily for repeated hypoglycemic episodes. Diazoxide administration was continued in combination with diet treatment until delivery. Glucose levels were well controlled. During gestational week 40, a male infant weighing 3069 g was delivered via spontaneous vaginal delivery with no pregnancy or neonatal complications. Diazoxide concentrations detected in maternal serum at 2.5–11.6 h after oral treatment ranged from 12.4 to 32.7 µg/mL. In cord blood, the diazoxide concentration was 18.5 µg/mL at 7.2 h after the last dose. During lactation, no hypoglycemia or hyperglycemia was observed. The approximate calculated ratio of diazoxide in breast milk and maternal serum was 0.09. The calculated daily infant dose was 0.47 mg/kg/day. The relative infant dose via breast milk ranged from 3.1% to 5.9%. Diazoxide transferred from maternal blood to the fetus across the placenta. It also transferred into breast milk, but there were no harmful effects on the infant. [ABSTRACT FROM AUTHOR]

The demand for tocilizumab is increasing in women who wish to bear children and who have active rheumatoid arthritis. Described here is a woman with rheumatoid arthritis who discontinued her tocilizumab therapy at the end of the first trimester and resumed it after delivery and where tocilizumab levels in maternal serum, infant serum, and the breast milk were measured. Tocilizumab was not detected in maternal serum just before delivery, or in umbilical cord blood or infant serum after birth. Tocilizumab levels in colostrum after intravenous injection were 0.57% of those in serum. Tocilizumab treatment in the first trimester was not associated with a significant drug level in the fetus at delivery and no fetal complications were noted. [ABSTRACT FROM AUTHOR]

The article discusses research which investigated safety of tocilizumab use during pregnancy and lactation. Topics explored include the intravenous tocilizumab dosage administered to a pregnant woman with adult-onset Still's disease (AOSD), measurement of tocilizumab concentrations in maternal serum, cord blood, and breast milk, and the health condition of the infant following exposure to tocilizumab.

The infant dose I via i breast milk was 0.95% of the maternal daily dose, that was considered to be acceptable,8 even though the drug information states that etizolam use should be avoided during breastfeeding.5 To clarify more accurate information about etizolam excretion into breastmilk, a detailed etizolam concentration profile including maximum concentration in breastmilk following oral etizolam administration will be required. Anxiety disorders may require pharmacological treatment, and it has been estimated that 10% to 26% of pregnant women with these disorders are prescribed benzodiazepines or benzodiazepine-like hypnotic drugs.1,2 These medications cross the placental and blood-brain barriers, may affect fetal growth and development,3 and have been associated with increased risks of preterm birth, low Apgar score, neonatal intensive care unit admission, and neonatal respiratory distress syndrome.4 Etizolam, a benzodiazepine-class anxiolytic, is prescribed for the treatment and management of agitation, tension, insomnia and anxiety.5 Due to the limited market distribution and use of etizolam worldwide, only one report from Japan published the information on etizolam transfer into breast milk.6 Furthermore, the information on etizolam transfer into the fetal circulation is limited. Benzodiazepine concentrations in the breast milk and plasma of nursing mothers: Estimation of relative infant dose. [Extracted from the article]