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Propranolol in human plasma and breast milk

  • John H. Bauer
    Correspondence
    Address for reprints: John H. Bauer, MD, Medical Services III, Harry S. Truman Memorial Veterans Hospital, Columbia, Missouri 65201.
    Affiliations
    From the Medical Services, Harry S. Truman Memorial Veterans Hospital Columbia, Missouri, USA

    From the Departments of Medicine, Pathology and Child Health, University of Missouri Medical Center, Columbia, Missouri, USA
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  • Brian Pape
    Affiliations
    From the Medical Services, Harry S. Truman Memorial Veterans Hospital Columbia, Missouri, USA

    From the Departments of Medicine, Pathology and Child Health, University of Missouri Medical Center, Columbia, Missouri, USA
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  • James Zajicek
    Affiliations
    From the Medical Services, Harry S. Truman Memorial Veterans Hospital Columbia, Missouri, USA

    From the Departments of Medicine, Pathology and Child Health, University of Missouri Medical Center, Columbia, Missouri, USA
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  • Ted Groshong
    Affiliations
    From the Medical Services, Harry S. Truman Memorial Veterans Hospital Columbia, Missouri, USA

    From the Departments of Medicine, Pathology and Child Health, University of Missouri Medical Center, Columbia, Missouri, USA
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      Abstract

      To assess the problem of continuing propranolol therapy in a breast-feeding mother, studies were performed to determine simultaneously plasma and breast milk concentrations of propranolol after single dose (40 mg) and continuous dose (40 mg 4 times daily) treatment with this drug. Breast milk and plasma concentrations of propranolol peaked between 2 and 3 hours after dosing. Propranolol concentrations in breast milk were less than 40 and 64 percent, respectively, of peak plasma propranolol concentrations after single dose and continuous dose administration. It was estimated that the maximal cumulative propranolol load to this breast-feeding infant, consuming 500 ml of whole milk, when the mother received 40 mg of propranolol 4 times daily would be 21 μg/24 hours. This dose is considerably less than the usual therapeutic dose of propranolol for infants.
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