Pharmacokinetics of piperaquine transfer into the breast milk of Melanesian mothers
Transfer of piperaquine (PQ) into breast milk was examined in 27 Papua New Guinean women given a 3-day course of dihydro-artemisinin-PQ or sulfadoxine-pyrimethamine-PQ during the second/third trimester. Breast milk was sampled on days 1, 2, 3 to 5, 7 to 11, and 14 to 17 postdelivery, a median of 70...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
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American Society for Microbiology
2015
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| Online Access: | http://hdl.handle.net/20.500.11937/14420 |
| _version_ | 1848748618331193344 |
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| author | Moore, B. Salman, S. Benjamin, J. Page-Sharp, Madhu Yadi, G. Batty, Kevin Siba, P. Mueller, I. Davis, T. |
| author_facet | Moore, B. Salman, S. Benjamin, J. Page-Sharp, Madhu Yadi, G. Batty, Kevin Siba, P. Mueller, I. Davis, T. |
| author_sort | Moore, B. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Transfer of piperaquine (PQ) into breast milk was examined in 27 Papua New Guinean women given a 3-day course of dihydro-artemisinin-PQ or sulfadoxine-pyrimethamine-PQ during the second/third trimester. Breast milk was sampled on days 1, 2, 3 to 5, 7 to 11, and 14 to 17 postdelivery, a median of 70 days postdose (range, 6 to 145 days). A blood sample was taken at delivery, and additional serial samples were available from 9 women who delivered within 42 days of dosing. Milk and plasma PQ were assayed by high-performance liquid chromatography. A population-based approach was used to model the log<inf>e</inf>(plasma) and milk concentration-time data. A sigmoid E<inf>max</inf> model best described PQ breast milk transfer. The population average milk: plasma PQ ratio was 0.58, with a peak of 2.5 at delivery. The model-derived maximum milk intake (148 ml/kg of body weight/day) was similar to the accepted value of 150 ml/kg/day. The median estimated absolute and relative cumulative infant PQ doses were 22 µg and 0.07%, respectively, corresponding to absolute and relative daily doses of 0.41 µg/kg and 0.004%. Model-based simulations for PQ treatment regimens given at birth, 1 week postdelivery, and 6 weeks postdelivery showed that the highest median estimated relative total infant dose (0.36%; median absolute total dose of 101 µg/kg) was seen after maternal PQ treatment 6 weeks postpartum. The maximum simulated relative total and daily doses from any scenario were 4.3% and 2.5%, respectively, which were lower than the recommended 10% upper limit. Piperaquine is transferred into breast milk after maternal treatment doses, but PQ exposure for suckling infants appears safe. |
| first_indexed | 2025-11-14T07:07:54Z |
| format | Journal Article |
| id | curtin-20.500.11937-14420 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:07:54Z |
| publishDate | 2015 |
| publisher | American Society for Microbiology |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-144202023-02-22T06:24:16Z Pharmacokinetics of piperaquine transfer into the breast milk of Melanesian mothers Moore, B. Salman, S. Benjamin, J. Page-Sharp, Madhu Yadi, G. Batty, Kevin Siba, P. Mueller, I. Davis, T. Transfer of piperaquine (PQ) into breast milk was examined in 27 Papua New Guinean women given a 3-day course of dihydro-artemisinin-PQ or sulfadoxine-pyrimethamine-PQ during the second/third trimester. Breast milk was sampled on days 1, 2, 3 to 5, 7 to 11, and 14 to 17 postdelivery, a median of 70 days postdose (range, 6 to 145 days). A blood sample was taken at delivery, and additional serial samples were available from 9 women who delivered within 42 days of dosing. Milk and plasma PQ were assayed by high-performance liquid chromatography. A population-based approach was used to model the log<inf>e</inf>(plasma) and milk concentration-time data. A sigmoid E<inf>max</inf> model best described PQ breast milk transfer. The population average milk: plasma PQ ratio was 0.58, with a peak of 2.5 at delivery. The model-derived maximum milk intake (148 ml/kg of body weight/day) was similar to the accepted value of 150 ml/kg/day. The median estimated absolute and relative cumulative infant PQ doses were 22 µg and 0.07%, respectively, corresponding to absolute and relative daily doses of 0.41 µg/kg and 0.004%. Model-based simulations for PQ treatment regimens given at birth, 1 week postdelivery, and 6 weeks postdelivery showed that the highest median estimated relative total infant dose (0.36%; median absolute total dose of 101 µg/kg) was seen after maternal PQ treatment 6 weeks postpartum. The maximum simulated relative total and daily doses from any scenario were 4.3% and 2.5%, respectively, which were lower than the recommended 10% upper limit. Piperaquine is transferred into breast milk after maternal treatment doses, but PQ exposure for suckling infants appears safe. 2015 Journal Article http://hdl.handle.net/20.500.11937/14420 10.1128/AAC.00327-15 American Society for Microbiology unknown |
| spellingShingle | Moore, B. Salman, S. Benjamin, J. Page-Sharp, Madhu Yadi, G. Batty, Kevin Siba, P. Mueller, I. Davis, T. Pharmacokinetics of piperaquine transfer into the breast milk of Melanesian mothers |
| title | Pharmacokinetics of piperaquine transfer into the breast milk of Melanesian mothers |
| title_full | Pharmacokinetics of piperaquine transfer into the breast milk of Melanesian mothers |
| title_fullStr | Pharmacokinetics of piperaquine transfer into the breast milk of Melanesian mothers |
| title_full_unstemmed | Pharmacokinetics of piperaquine transfer into the breast milk of Melanesian mothers |
| title_short | Pharmacokinetics of piperaquine transfer into the breast milk of Melanesian mothers |
| title_sort | pharmacokinetics of piperaquine transfer into the breast milk of melanesian mothers |
| url | http://hdl.handle.net/20.500.11937/14420 |