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Nexium use in lactating mothers

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  • Nexium use in lactating mothers

    Hi,

    I have a patient that is asking about the risks of nexium for the infant with a mother who is breast feeding. She was concerned as the pharmacy paperwork says not the take the medicine if breast feeding. My database states that there are no studies, the medication website states that there was tumorgenicity in rats and recommends risk benefit analysis . Any insight would be helpful?

    Jared

  • #2
    Esomeprazole (Nexiuim)

    Jdant:

    Esomeprazole is a typical proton pump inhibitor just like all the rest of them. As such, it is totally destroyed in the stomach when ingested. Thus, if small amounts were to be ingested via milk, it would be rapidly destroyed in the acidity of the infants stomach...and virtually none would be absorbed.

    I think this product and all the PPIs are probably safe to use. Below is the data for omeprazole, its prodrug.

    Tom Hale Ph.D.


    Omeprazole is a potent inhibitor of gastric acid secretion. In a study of one patient receiving 20 mg omeprazole daily, the maternal serum concentration was negligible until 90 minutes after ingestion and then reached 950 nM at 240 min.[1] The breastmilk concentration of omeprazole began to rise minimally at 90 minutes after ingestion and peaked after 180 minutes at only 58 nM, or less than 7% of the highest serum level. This would indicate a maximum dose of 3 µg/kg/day in a breastfed infant. Omeprazole milk levels were essentially flat over 4 hours of observation. Omeprazole is extremely acid labile with a half-life of 10 minutes at pH values below 4.[2] Virtually all omeprazole ingested via milk would probably be destroyed in the stomach of the infant prior to absorption.

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    • #3
      Dr. Hale

      Thanks for the response and input. What are your thoughts concerning nexium use during pregnancy for the fetus?

      Jared

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      • #4
        nexium should not be taken without doctor consultation. FDA have given B rating to this drug which indicate its not harmful for fetus and its development. This medication has not shown any symtoms of passing through mother milk to baby.

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        • #5
          Has the post from Dr Hale been intentionally deleted? There used to be a post in these forums about taking 40mg of nexium twice a day while breastfeeding and I can no longer find it. I did this after my last pregnancy and need to again due to extra reflux during pregnancy.

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