Transfer of parecoxib and its primary active metabolite valdecoxib via transitional breastmilk following intravenous parecoxib use after cesarean delivery: a comparison of naive pooled data analysis and nonlinear mixed-effects modeling

Anesthesia and Analgesia
Michael PaechNeil A Muchatuta

Abstract

Multimodal analgesia, including nonopioid analgesics, is usually used for several days after cesarean delivery. Because the breastfed infant receives transitional milk during this same period, it is important to know how much of a maternal analgesic drug is received by the infant. We designed this study to estimate infant exposure to parecoxib and its active metabolite valdecoxib (a cyclooxygenase-2 inhibitor) after a single IV maternal dose of parecoxib after cesarean delivery. Forty women and their infants participated in the study. Parecoxib (40 mg) was administered IV at a mean of 41 hours after birth. Milk (4 samples) and plasma (1 sample) were collected from the women over the subsequent 24 hours and drug content was measured by liquid chromatography-tandem mass spectrometry. The infants were assessed the day after parecoxib dosing. Absolute (AID) and relative infant doses (RID) of both parecoxib and valdecoxib through milk were estimated by standard methods using the naïve pooled datasets, and where possible milk/plasma (M/P) concentration ratios were calculated. Nonlinear mixed-effects modeling was also used to fit the valdecoxib milk and plasma datasets to a compartmental model and to predict M/P, AID, and RID. M/P rat...Continue Reading

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Citations

Feb 8, 2018·Pharmaceutical Research·Philip O Anderson
Aug 1, 2015·BMC Veterinary Research·M SchneiderF Woehrlé
Apr 6, 2013·Anesthesia and Analgesia·Melanie Bloor, Michael Paech
Apr 10, 2016·Clinical Pharmacology and Therapeutics·Philip O Anderson, Jason B Sauberan
Apr 19, 2015·Current Opinion in Anaesthesiology·Alexandra M J V Schyns-van den BergRobert Jan Stolker
Feb 1, 2013·Anaesthesia and Intensive Care·T C ChuM F Yii

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