Dikloron ve emziren anne

Sayın Hüseyin Dirican, Öncelikle bebeğiniz hayırlı olsun. Dikloron'on etken maddesi olan diklofenak, emziren anneler kullandığında çok az (kabul edilebilir) miktarlarda bebeğe geçtiği bilinmektedir. Bu yüzden bazı hekimler kullanılmasını uygun bulmaz iken diğer bazıları da kullanılabilir demektedir. Bu konuya yayınlanmış fazla bir bilgi literatürde yoktur. Ancak eğer ingilizce biliyorsanız ben size bazı aydınlatıcı bilgileri aşağıda ilave ettim. Bu bilgiler de iki olay anlatılıyot. Emziren iki anne dikloron kullanıyor, birinin bebeğinde hiçbir yan etti görülmez iken diğerinin bebeğinde allerjik sayılabilecek deri döküntüsü (kızarıklık) görülüyor. Umarım aydınlatabilmişimdir. Saygılarımla, Diclofenac Levels and Effects while Breastfeeding Summary of Use during Lactation Data on excretion of diclofenac into milk are poor, but the drug has a short half-life and little glucuronide metabolite formation. Most reviewers consider diclofenac to be acceptable during breastfeeding.[1][2][3][4] Other agents having more published information may be preferred, especially while nursing a newborn or preterm infant. Drug Levels No original data on the excretion of diclofenac into milk are available. Data are limited to those reported in review articles in which no study details are reported. Diclofenac was undetectable (<100 mcg/L) in the breastmilk over a 6-hour period after a 50 mg intramuscular injection in 6 women.[5][6] Six mothers were given oral diclofenac 100 mg daily orally for one week postpartum. The drug was undetectable(<10 mcg/L) in milk of any of 59 samples of milk collected (collection times unspecified).[6] A woman treated with 150 mg daily of diclofenac had a breastmilk diclofenac level of 100 mcg/L, equivalent to about 0.03 mg/kg daily for the infant.[7] Effects in Breastfed Infants In one study, 30 mothers undergoing elective cesarean section were allowed to use 25 mg diclofenac suppositories along with either spinal or spinal and epidural anesthesia with a local anesthetic after delivery. The spinal anesthetic group used an average of 56 mg of diclofenac on the day of delivery and 33 mg on the next day whereas the women receiving both spinal and epidural anesthesia used 21 and 18 mg. No mention was made of adverse effects on the breastfed infants.[8] An breastfed infant developed urticaria on day 15 of life. Her mother had been taking diclofenac (dosage unspecified) for pain since her cesarean section delivery. Diclofenac is a possible cause of the urticaria; however, the infant had also received hepatitis B vaccination 7 days before and the authors thought that it was a more likely cause of the reaction.[9] 1. Brooks PM, Needs CJ. Antirheumatic drugs in pregnancy and lactation. Baillieres Clin Rheumatol. 1990;4:*** *** **. PMID: *** *** **. Ostensen ME. Safety of non-steroidal anti-inflammatory drugs during pregnancy and lactation. Inflammopharmacology. 1996;4:31-41. 3. Spigset O, Hagg S. Analgesics and breast-feeding: safety considerations. Paediatr Drugs. 2000;2(3):*** *** **. PMID: *** *** **. Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy and lactation. Arch Intern Med. 2000;160:610-9. PMID: *** *** **. Fowler PD. Voltarol: diclofenac sodium. Clin Rheum Dis. 1979;5:*** *** **. 6. Sioufi A, Stierlin H, Schweizer A et al. Recent findings concerning clinically relevant pharmacokinetics of diclofenac sodium. In: Kass E. Voltaren new findings. Bern: Hans Huber Publishers, 1982:19-30. 7. Todd PA, Sorkin EM. Diclofenac sodium. A reappraisal of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. Drugs. 1988;35:*** *** **. PMID: *** *** **. Hirose M, Hara Y, Hosokawa T et al. The effect of postoperative analgesia with continuous epidural bupivacaine after cesarean section on the amount of breast feeding and infant weight gain. Anesth Analg. 1996;82:*** *** **. PMID: *** *** **. De Cerqueira AM, De Azevedo JO, Guimaraes MB, Afradique MC. Urticaria in a newborn. J Am Acad Dermatol. 2009;60:Abstract 148.

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