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Baker T, Lorch U, Bagger Y, Holmqvist C, Jonker DM, Urban LE, Hale TW. No Measurable Transfer of Oxytocin-Receptor Agonist Merotocin Detected in Human Breast Milk. Breastfeed Med 2024; 19:451-458. [PMID: 38529915 DOI: 10.1089/bfm.2024.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Objective: The study aimed to assess the transfer of merotocin from systemic circulation to breast milk in early postpartum women and women with established lactation. Methods: This was a two-part, multicenter, open-label, parallel-group study. Merotocin was administered as a single 90-minute intravenous (iv) infusion mimicking the intranasal pharmacokinetic profile. In Part A, 12 early postpartum women received doses of either 4 μg (n = 6) or 16 μg (n = 6) of merotocin within 4 days of delivery. In Part B, six women with established lactation received 20 μg of merotocin. The total concentration of merotocin in plasma and breast milk and its metabolites excreted in breast milk were measured at various time points. Adverse events (AEs) were also assessed for both parts of the study. Results: In both early postpartum and established lactation groups (mean age, 26.3 years; 83.3% Caucasian), merotocin and its metabolites in breast milk were below the limit of quantification (25.0 pg/mL) at all time points. Sixteen treatment-emergent AEs occurred in early postpartum women only, including seven events of uterine spasm and three of breast engorgement. There was one moderate event, whereas all the other events were considered mild. Conclusion: Merotocin was undetectable in breast milk after single iv administration of up to 20 μg in early postpartum women and women with established lactation.
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Affiliation(s)
- Teresa Baker
- Texas Tech University Health Sciences Center School of Medicine, Amarillo, Texas, USA
| | | | - Yu Bagger
- Ferring Pharmaceuticals, A/S, Copenhagen, Denmark
| | | | | | - Lorien E Urban
- Ferring Pharmaceuticals, Inc., Parsippany, New Jersey, USA
| | - Thomas W Hale
- Texas Tech University Health Sciences Center School of Medicine, Amarillo, Texas, USA
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Puoti MG, Assa A, Benninga M, Broekaert IJ, Carpi FJM, Deganello Saccomani M, Dolinsek J, Homan M, Mas E, Miele E, Tzivinikos C, Thomson M, Borrelli O. Drugs in Focus: Domperidone. J Pediatr Gastroenterol Nutr 2023; 77:e13-e22. [PMID: 37159421 DOI: 10.1097/mpg.0000000000003822] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Domperidone is a peripheral dopamine-2 receptor antagonist with prokinetic and antiemetic properties. Its prokinetic effects are mainly manifest in the upper gastrointestinal (GI) tract. Currently its use is restricted to relief of nausea and vomiting in children older than 12 years for a short period of time. However, among (pediatric) gastroenterologists, domperidone is also used outside its authorized indication ("off label") for treatment of symptoms associated with gastro-esophageal reflux disease, dyspepsia, and gastroparesis. Little is known about its efficacy in the treatment of GI motility disorders in children and controversial data have emerged in the pediatric literature. As its use is off label, appropriate knowledge of its efficacy is helpful to support an "off label/on evidence" prescription. Based on this, the purpose of this review is to summarize all evidence on the efficacy of domperidone for the treatment of GI disorders in infants and children and to report an overview of its pharmacological properties and safety profile.
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Affiliation(s)
- Maria Giovanna Puoti
- From the Department of Paediatric Gastroenterology, Great Ormond Street Hospital for Children, London, UK
| | - Amit Assa
- The Juliet Keidan Institute of Paediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University, Jerusalem, Israel
| | - Marc Benninga
- the Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Ilse Julia Broekaert
- the Department of Paediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Francisco Javier Martin Carpi
- the Department of Paediatric Gastroenterology, Hepatology and Nutrition, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Jernej Dolinsek
- the Department of Gastroenterology, Hepatology and Nutrition, University Medical Centre Maribor, Maribor, Slovenia
| | - Matjaz Homan
- the Department of Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Emmanuel Mas
- the Service de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, F-31300 Toulouse, France, and IRSD, Université de Toulouse, INSERM, INRAE, ENVT, UPS, Toulouse, France
| | - Erasmo Miele
- the Department of Translational Medicine Science, Section of Paediatrics, University of Naples "Federico II", Naples, Italy
| | - Christos Tzivinikos
- the Paediatric Gastroenterology Department, Al Jalila Children's Specialty Hospital, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Mike Thomson
- the Centre for Paediatric Gastroenterology, Sheffield Children's Hospital, Weston Bank, Sheffield, UK
| | - Osvaldo Borrelli
- From the Department of Paediatric Gastroenterology, Great Ormond Street Hospital for Children, London, UK
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