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Digicap Pregnancy |
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Digicap crosses the placenta.
Available guidelines note experience with Digicap in pregnancy is extensive (ESG [Regitz-Zagrosek 2018]). Based on available data, an increased risk of adverse pregnancy outcomes has not been observed. However, untreated maternal heart failure and atrial fibrillation may increase the risk of preterm birth and low birth weight, respectively. The manufacturer recommends monitoring neonates for signs and symptoms of Digicap toxicity following in utero exposure.
Due to pregnancy-induced physiologic changes, some pharmacokinetic properties of Digicap may be altered. Close monitoring of maternal serum Digicap is recommended (Hebert 2008; Luxford 1983; Martin-Suarez 2017); dose adjustments may be required during pregnancy and postpartum.
Heart failure and atrial fibrillation may worsen during pregnancy. Digicap is recommended as a first-line agent for the chronic treatment of highly symptomatic supraventricular tachycardia (SVT) in pregnancy; the lowest effective dose is recommended (ACC/AHA/HRS [Page 2015]). Digicap may be considered for long-term rate control of maternal atrial tachycardia or atrial fibrillation when preferred agents fail (ESG [Regitz-Zagrosek 2018]). Monitor for an increased risk of maternal arrhythmias during labor and delivery.
Digicap may be considered for the in utero management of fetal SVT or atrial flutter with hydrops or ventricular dysfunction. Digicap may also be considered for SVT without hydrops or ventricular dysfunction if heart rate is ≥200 bpm, atrial flutter, or other rare tachycardias with an average heart rate of ≥200 bpm (AHA [Donofrio 2014]).
Caution is recommended. Excreted into human milk: Yes (in small amounts) Comments: This drug has been used without apparent harmful effects in the nursing infant.
This drug is excreted into breast milk in small amounts, and therefore, any amount ingested through breastfeeding would not be expected to cause adverse effects in the nursing infant. If the mother is scheduled to receive this drug intravenously, some experts recommend avoidance of breastfeeding for 2 hours after the dose to lessen the amount received by the infant.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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