Z Geburtshilfe Neonatol 2022; 226(01): 48-55
DOI: 10.1055/a-1520-5233
Original Article

Drugs in Pregnancy and Lactation – Medications used in Swiss Obstetrics

II. Lactation
Larissa Schenkel
1   Obstetrics, University Hospital Zurich, Zurich, Switzerland
,
Ana Paula Simões-Wüst
1   Obstetrics, University Hospital Zurich, Zurich, Switzerland
,
Irene Hösli
2   Obstetrics, University Hospital Basel, Basel, Switzerland
,
Ursula von Mandach
1   Obstetrics, University Hospital Zurich, Zurich, Switzerland
› Institutsangaben

Abstract

Background In order to improve the safety of drugs in pregnancy and lactation, it is imperative that data on clinical practice be collected and validated.

Methods Data on routinely used medications were requested from 9 Swiss perinatal centres (5 university hospitals for obstetrics and 4 non-university centres). Furthermore, recommendations and guidelines from scientific societies for the fields of application were sought.

Results Part II (lactation): For the lactation period, 48 different active substances were each identified by at least 4 centres. The active constituents most frequently cited by the centres were i. v. iron, lorazepam, nifedipine and paracetamol. Only a few guidelines were found that explicitly refer to the breastfeeding period. Therefore, fewer recommendations for use during lactation could be found compared with during pregnancy.

Conclusion As with during pregnancy, the same active ingredients are consistently used in Swiss perinatal centres for many different indications during lactation. Most of these active ingredients are labelled with a warning or are even considered to be contraindicated; their use is therefore mainly off-label. Official authorisation for frequently or consistently used active substances is urgently needed. With this study, a first important step towards national harmonisation has been taken.



Publikationsverlauf

Eingereicht: 11. Februar 2021

Angenommen nach Revision: 20. Mai 2021

Artikel online veröffentlicht:
22. Juli 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Schenkel L, Simões-Wüst AP, Hösli I, von Mandach U. Drugs in pregnancy and lactation – medications used in Swiss obstetrics. I. Pregnancy and Perinatal Period. Z Geburtshilfe Neonatol 2018; 222: 152-165
  • 2 Ito S. Mother and child: medication use in pregnancy and lactation. Clin Pharmacol Ther 2016; 100: 8-11.
  • 3 www.swissmedic.ch 2017 [Online Dec 2020]
  • 4 Schaefer C, Spielmann H, Vetter K, Weber-Schöndorfer C. Arzneimittel in Schwangerschaft und Sillzeit. 8. Aufl. München: Urban & Fischer/Elsevier GmbH; 2012
  • 5 Anderson PO. Drugs in lactation. Pharm Res 2018; 35: 45.
  • 6 Hotham N, Hotham E. Drugs in breastfeeding. Aust Prescr 2015; 38: 156-159
  • 7 Friese K, Mörike K, Neumann G, Windorfer A. Arzneimittel in Schwangerschaft und Stillzeit. 8. Aufl. Stuttgart: Wissenschaftliche Verlagsgesellschaft;; 2016
  • 8 Veiby G, Engelsen B, Gilhus N. Early child development and exposure to antiepileptic drugs prenatally and through breastfeeding. JAMA Neurol 2013; 70: 1367-1374.
  • 9 Schenkel Larissa. Medikamente in der Geburtshilfe – Verwendung in den Schweizer Hauptzentren Masterarbeit in Pharmazie. Departement Pharmazeutische Wissenschaften Universität Basel. 2015