6 Interactions found for:

The following applies to the ingredients: Doxycycline

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Use is not recommended unless clearly needed. Use should be avoided during the second and third trimesters of pregnancy.
-According to some authorities: Use of most oral formulations is contraindicated; use of the 40 mg capsule formulation is contraindicated during the second and third trimesters.

AU TGA pregnancy category: D
US FDA pregnancy category: Not assigned.

Risk summary: Use of this drug in pregnant women may cause fetal harm. Use during the second and third trimesters may cause reversible inhibition of bone growth and permanent discoloration of deciduous teeth.

Comments:
-According to some authorities: Tetracyclines are considered safe for use during the first 18 weeks of pregnancy.
-If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus.

Animal studies have revealed evidence of embryofetal toxicity, including toxic effects on skeletal formation. Animal studies indicate this drug crosses the placenta and is found in fetal tissues. There are no controlled data in human pregnancy.

Most reported human experience was short-term, first trimester exposure but no human data are available assessing long-term therapy during pregnancy (e.g., regimen for anthrax exposure). An expert review of data regarding use of this drug during pregnancy by the Teratogen Information System (TERIS) concluded that substantial teratogenic risk from therapeutic doses during pregnancy is unlikely (data quantity and quality limited to fair); insufficient data to state there is no risk.

AU TGA pregnancy category D: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

The following applies to the ingredients: Apixaban (found in Eliquis)

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Use is not recommended.

AU TGA pregnancy category: C
US FDA pregnancy category: Not assigned.

Risk Summary: Insufficient data exists to inform drug-associated risks of major birth defects, miscarriage, or adverse developmental outcomes.

Comments:
-Treatment can cause uterine bleeding, that may require gynecological surgical intervention.
-Treatment can cause placental hemorrhage and subsequent fetal loss.
-This drug may increase the risk of bleeding in the fetus and neonate.
-Females of reproductive potential that require anticoagulation should discuss pregnancy planning options with their healthcare provider.

Animal studies have failed to reveal evidence of adverse developmental effects. There are no controlled data in human pregnancy.

Use of this drug during labor or delivery in women receiving neuraxial anesthesia may result in epidural or spinal hematomas.

AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

The following applies to the ingredients: Doxycycline

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LactMed: Short-term use is considered acceptable; as a precaution (theoretical), prolonged or repeat courses should be avoided throughout breastfeeding.
-IV: The manufacturer makes no recommendation regarding use during lactation.
-Oral: According to some authorities and manufacturers, a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother; according to other authorities and manufacturers, use is contraindicated. Use of the 40 mg capsule formulation is not recommended.

Excreted into human milk: Yes

Comments:
-According to at least 1 manufacturer: Developmental and health benefits of breastfeeding should be considered as well as the mother's clinical need for the drug; potential side effects in the breastfed child due to the drug or the mother's underlying condition should be considered.
-The effects in the nursing infant are unknown; the infant should be monitored for rash and possible effects on the gastrointestinal flora (e.g., diarrhea or candidiasis [thrush, diaper rash]).
-Tetracycline, a related drug, is considered compatible with breastfeeding by the American Academy of Pediatrics.

Tetracyclines have been considered contraindicated during breastfeeding due to possible staining of infants' dental enamel or bone deposition of tetracyclines; however, a close review of available literature suggests harmful effects are unlikely with short-term use of this drug during lactation as milk levels are low and infant absorption is inhibited by the calcium in breast milk.

According to some experts, this drug is compatible for short courses (e.g., 10 days) if alternative therapy is not appropriate; diarrhea may occur in the nursing infant.

The extent of drug absorption by breastfed infants is unknown. Short-term use in lactating women is not explicitly contraindicated by most manufacturers, but the effects of prolonged drug exposure via breast milk are unknown. Long-term or repeat courses are not recommended during nursing as a theoretical precaution. Theoretical risks of dental staining and inhibition of bone growth in nursing infants are considered unlikely by most experts.

After 2 oral doses (200 mg followed by 100 mg 12 hours later) in 15 nursing mothers, milk drug levels 3 and 24 hours after dosing averaged 0.77 mg/L (range: 0.4 to 1.4 mg/L) and 0.38 mg/L (range: 0.12 to 0.85 mg/L), respectively.

This drug (100 mg/day) was given orally to 10 mothers. On day 2, milk drug levels 3 and 24 hours after dosing averaged 0.82 mg/L (range: 0.37 to 1.24 mg/L) and 0.46 mg/L (range: 0.3 to 0.91 mg/L), respectively. Using peak and trough milk level averages in this study, the estimated intake of an infant only fed breast milk averaged about 6% of the maternal weight-adjusted dose.

Peak milk levels averaged 0.96 mg/L after a single 100 mg dose (n=3) and 1.8 mg/L after a single 200 mg dose (n=3). After 100 mg orally twice a day for 5 days, milk drug levels were about 3.6 mg/L.

In another study, in the immediate postpartum period, peak milk levels were 0.6 mg/L after oral doses of 100 mg (n=3) and averaged 1.1 mg/L after 200 mg (n=11).

After a single 200 mg dose (n=2), milk levels 2, 4, and 6 hours after dosing averaged 0.8, 0.7, and 0.4 mg/L, respectively.

The following applies to the ingredients: Apixaban (found in Eliquis)

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A decision should be made to discontinue breast-feeding or discontinue the drug, taking into account the importance of the drug to the mother.

Excreted into human milk: Unknown
Excreted into animal milk: Yes

The effects in the nursing infant are unknown.

Animal studies in lactation did not result in death of offspring. The drug was excreted in the milk of the animal model at a high milk to plasma ratio, possibly due to active transport.