論文

査読有り
2017年10月

Quantitative prediction of fetal plasma concentration of fluvoxamine during dosage-tapering to the mother

PLACENTA
  • Sayo Matsuoka
  • ,
  • Satoko Hori
  • ,
  • Hiroki Satoh
  • ,
  • Takeshi Nagamatsu
  • ,
  • Tomoyuki Fujii
  • ,
  • Yasufumi Sawada

58
開始ページ
74
終了ページ
81
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.placenta.2017.08.010
出版者・発行元
W B SAUNDERS CO LTD

Introduction: Although selective serotonin reuptake inhibitors have been used during pregnancy for the treatment of depression and anxiety disorders, the fetal plasma concentration profiles of them remained unclear. Therefore, the aim of this study was to develop a pharmacokinetic model to estimate fetal plasma concentration profiles of fluvoxamine, and to clarify the differences with those of paroxetine.
Methods: Perfusion studies using human placentae obtained from full-term pregnant women were conducted to estimate transplacental pharmacokinetic parameters for fluvoxamine. The characteristics of placental permeability were compared with those of paroxetine in our previous report. Using a developed model and these parameters, fetal plasma concentration profiles of fluvoxamine administered to mothers were simulated.
Results: The results of perfusion studies and transplacental transfer kinetic parameters indicated that fluvoxamine is less efficiently distributed to placental tissue than paroxetine. The model predicted a maternal-fetal plasma concentration ratio of 0.376 after repeated maternal administration of fluvoxamine, similar to the ratio for paroxetine. However, if the mother ceased taking drug, the model predicted a half-life of fluvoxamine in fetal plasma of 35 h, which is longer than that of paroxetine (10 h). We used the model to evaluate a proposed taper regimen for full-term pregnant women taking fluvoxamine that would minimize the risk of neonatal withdrawal syndrome.
Discussion: The obtained parameters and developed model enabled us to predict the fetal plasma concentration profiles of fluvoxamine. The risk of neonatal withdrawal syndrome due to abrupt discontinuation may be less with fluvoxamine than with paroxetine. (C) 2017 Elsevier Ltd. All rights reserved.

Web of Science ® 被引用回数 : 1

リンク情報
DOI
https://doi.org/10.1016/j.placenta.2017.08.010
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28962699
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000413663200011&DestApp=WOS_CPL

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