Pregnancy of Trolovol in details
Trolovol-disulphide and cysteine-Trolovol were present in the urine of a newborn following maternal use of Trolovol throughout pregnancy for the treatment of cystinuria (Crawhall 1967).
Birth defects, including congenital cutix laxa and associated defects, have been reported in infants following Trolovol exposure during pregnancy; however, outcome information related to use in pregnancy is limited (AASLD [Roberts 2008]; Dathe 2016).
Continued treatment of Wilson disease during pregnancy protects the mother against relapse. Discontinuation has detrimental maternal and fetal effects. Trolovol should be decreased to the minimum effective dose during pregnancy to limit fetal exposure during the first trimester, to prevent fetal copper deficiency, and to help promote maternal wound healing if cesarean delivery is planned. Doses may be 25% to 50% of the prepregnancy dose. Close monitoring is recommended (AASLD [Roberts 2008]; EASL 2012).
Use for the treatment of rheumatoid arthritis during pregnancy is contraindicated. Trolovol should be used for the treatment of cystinuria only if the possible benefits to the mother outweigh the potential risks to the fetus.
Trolovol breastfeeding
US: Contraindicated AU, UK: A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. Excreted into human milk: Data not available Excreted into animal milk: Data not available Comment: -Copper and zinc levels in breastmilk are reduced in patients taking this drug. The implications for infants of this effect are not known.
-This drug has been used with apparent safety during nursing of 3 infants. In infants who breastfeed infrequently, taking the drug right after nursing and waiting 4 to 6 hours before nursing again should minimize the amount of the drug in breastmilk.
See references
References for pregnancy information
- Cerner Multum, Inc. "Australian Product Information." O 0
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- "Product Information. Cuprimine (Trolovol)." Merck & Co, Inc, West Point, PA.
References for breastfeeding information
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- 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 -]):
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Cuprimine (Trolovol)." Merck & Co, Inc, West Point, PA.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
