Lithiumcarbonaat PCH Pregnancy

• Pregnancy of Lithiumcarbonaat PCH in details
• Lithiumcarbonaat PCH breastfeeding
• Lithiumcarbonaat PCH reviews

Pregnancy of Lithiumcarbonaat PCH in details

Lithiumcarbonaat PCH crosses the placenta in concentrations similar to those in the maternal plasma (Newport 2005).

Cardiac malformations in the infant, including Ebstein anomaly, are associated with use of Lithiumcarbonaat PCH during the first trimester of pregnancy. Other adverse events including polyhydramnios, fetal/neonatal cardiac arrhythmias, hypoglycemia, diabetes insipidus, changes in thyroid function, premature delivery, floppy infant syndrome, or neonatal Lithiumcarbonaat PCH toxicity are associated with Lithiumcarbonaat PCH exposure when used later in pregnancy (ACOG 2008). The incidence of adverse events may be associated with higher maternal doses (Newport 2005). Fetal echocardiography should be considered if first trimester exposure occurs (ACOG 2008).

Due to pregnancy-induced physiologic changes, women who are pregnant may require dose adjustments of Lithiumcarbonaat PCH to achieve euthymia and avoid toxicity (ACOG 2008; Grandjean 2009; Yonkers 2011).

For planned pregnancies, use of Lithiumcarbonaat PCH during the first trimester should be avoided if possible (Grandjean 2009). However, the absolute risk of Ebstein anomaly is small and treatment for bipolar disorder should not be withheld when clinically indicated (Larsen 2015). If Lithiumcarbonaat PCH is needed during pregnancy, the minimum effective dose should be used, maternal serum concentrations should be monitored, and consideration should be given to start therapy after the period of organogenesis; Lithiumcarbonaat PCH should be suspended 24 to 48 hours prior to delivery or at the onset of labor when delivery is spontaneous, then restarted when the patient is medically stable after delivery (ACOG 2008; Grandjean 2009; Newport 2005).

Lithiumcarbonaat PCH breastfeeding

Excretion of this drug into breastmilk is highly variable. There have been reports of breastfed infants who have shown signs/symptoms associated with Lithiumcarbonaat PCH toxicity (e.g., hypertonia, hypothermia, cyanosis, and ECG changes); this may occur more frequently in infants with elimination impairments (e.g., dehydration) or in newborn/premature infants.

Use is contraindicated (AU, UK) Use is not recommended and a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother (US) Excreted into human milk: Yes Comments: -Bottle feeding is recommended due to the risk of Lithiumcarbonaat PCH toxicity. -If breastfeeding is continued, monitoring of infant serum Lithiumcarbonaat PCH, serum creatinine, blood urea nitrogen, and thyroid stimulating hormone levels are recommended.

See references

References for pregnancy information

1. Cerner Multum, Inc. "Australian Product Information." O 0
2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
3. "Product Information. Lithobid (Lithiumcarbonaat PCH)." Ciba Pharmaceuticals, Summit, NJ.
4. "Product Information. Eskalith (Lithiumcarbonaat PCH)." SmithKline Beecham, Philadelphia, PA.

References for breastfeeding information

1. United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]):
2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
3. "Product Information. Lithobid (Lithiumcarbonaat PCH)." Ciba Pharmaceuticals, Summit, NJ.
4. Cerner Multum, Inc. "Australian Product Information." O 0
5. "Product Information. Eskalith (Lithiumcarbonaat PCH)." SmithKline Beecham, Philadelphia, PA.

Reviews

Consumer reviews

Information checked by Dr. Sachin Kumar, MD Pharmacology