Ivermectin concentration in breastmilk of a woman with Strongyloides stercoralis and human T-lymphotropic virus-I co-infection

Research output: Contribution to journalArticle

Abstract

Ivermectin is a widely used drug for the treatment of various neglected tropical diseases, such as lymphatic filariasis, onchocerciasis, and strongyloidiasis among others. Despite its excellent safety profile, there are few published studies of the use of ivermectin in children, pregnant and nursing women. In the present study, we report clinical data on ivermectin concentrations in breastmilk of a woman with Strongyloides stercoralis and HTLV-I coinfection. Ivermectin levels in breastmilk ranged from 1.4 to 20.8 ng/ml, with a mean of 9.26 ng/ml after a single dose of 200 µg/kg. We estimated the possible ivermectin exposure of the infant to be 1.1 µg/kg, 0.55% of the weight-adjusted percentage of the maternal dose. This value is largely under the threshold established by the World Health Organization for safe breastfeeding. Our results bolster previous findings on the secretion of ivermectin into breastmilk in healthy volunteers. The findings from this case study do not support exclusion of lactating women or interrupting lactation to accommodate it.

Original languageEnglish
Pages (from-to)105249
JournalActa Tropica
Volume202
DOIs
Publication statusE-pub ahead of print - Oct 31 2019

Fingerprint

Strongyloides stercoralis
Ivermectin
ivermectin
Coinfection
mixed infection
Viruses
viruses
breast feeding
strongyloidiasis
Strongyloidiasis
Neglected Diseases
onchocerciasis
Filarial Elephantiasis
Onchocerciasis
filariasis
lactating women
Human T-lymphotropic virus 1
World Health Organization
dosage
Breast Feeding

Cite this

@article{9185d0ad26644f369291307b00d07ea7,
title = "Ivermectin concentration in breastmilk of a woman with Strongyloides stercoralis and human T-lymphotropic virus-I co-infection",
abstract = "Ivermectin is a widely used drug for the treatment of various neglected tropical diseases, such as lymphatic filariasis, onchocerciasis, and strongyloidiasis among others. Despite its excellent safety profile, there are few published studies of the use of ivermectin in children, pregnant and nursing women. In the present study, we report clinical data on ivermectin concentrations in breastmilk of a woman with Strongyloides stercoralis and HTLV-I coinfection. Ivermectin levels in breastmilk ranged from 1.4 to 20.8 ng/ml, with a mean of 9.26 ng/ml after a single dose of 200 µg/kg. We estimated the possible ivermectin exposure of the infant to be 1.1 µg/kg, 0.55{\%} of the weight-adjusted percentage of the maternal dose. This value is largely under the threshold established by the World Health Organization for safe breastfeeding. Our results bolster previous findings on the secretion of ivermectin into breastmilk in healthy volunteers. The findings from this case study do not support exclusion of lactating women or interrupting lactation to accommodate it.",
author = "Paola Rodari and Dora Buonfrate and Elena Pomari and Gianluigi Lunardi and Isabella Bon and Zeno Bisoffi and Andrea Angheben",
note = "Copyright {\circledC} 2019 Elsevier B.V. All rights reserved.",
year = "2019",
month = "10",
day = "31",
doi = "10.1016/j.actatropica.2019.105249",
language = "English",
volume = "202",
pages = "105249",
journal = "Acta Tropica",
issn = "0001-706X",
publisher = "Elsevier",

}

TY - JOUR

T1 - Ivermectin concentration in breastmilk of a woman with Strongyloides stercoralis and human T-lymphotropic virus-I co-infection

AU - Rodari, Paola

AU - Buonfrate, Dora

AU - Pomari, Elena

AU - Lunardi, Gianluigi

AU - Bon, Isabella

AU - Bisoffi, Zeno

AU - Angheben, Andrea

N1 - Copyright © 2019 Elsevier B.V. All rights reserved.

PY - 2019/10/31

Y1 - 2019/10/31

N2 - Ivermectin is a widely used drug for the treatment of various neglected tropical diseases, such as lymphatic filariasis, onchocerciasis, and strongyloidiasis among others. Despite its excellent safety profile, there are few published studies of the use of ivermectin in children, pregnant and nursing women. In the present study, we report clinical data on ivermectin concentrations in breastmilk of a woman with Strongyloides stercoralis and HTLV-I coinfection. Ivermectin levels in breastmilk ranged from 1.4 to 20.8 ng/ml, with a mean of 9.26 ng/ml after a single dose of 200 µg/kg. We estimated the possible ivermectin exposure of the infant to be 1.1 µg/kg, 0.55% of the weight-adjusted percentage of the maternal dose. This value is largely under the threshold established by the World Health Organization for safe breastfeeding. Our results bolster previous findings on the secretion of ivermectin into breastmilk in healthy volunteers. The findings from this case study do not support exclusion of lactating women or interrupting lactation to accommodate it.

AB - Ivermectin is a widely used drug for the treatment of various neglected tropical diseases, such as lymphatic filariasis, onchocerciasis, and strongyloidiasis among others. Despite its excellent safety profile, there are few published studies of the use of ivermectin in children, pregnant and nursing women. In the present study, we report clinical data on ivermectin concentrations in breastmilk of a woman with Strongyloides stercoralis and HTLV-I coinfection. Ivermectin levels in breastmilk ranged from 1.4 to 20.8 ng/ml, with a mean of 9.26 ng/ml after a single dose of 200 µg/kg. We estimated the possible ivermectin exposure of the infant to be 1.1 µg/kg, 0.55% of the weight-adjusted percentage of the maternal dose. This value is largely under the threshold established by the World Health Organization for safe breastfeeding. Our results bolster previous findings on the secretion of ivermectin into breastmilk in healthy volunteers. The findings from this case study do not support exclusion of lactating women or interrupting lactation to accommodate it.

U2 - 10.1016/j.actatropica.2019.105249

DO - 10.1016/j.actatropica.2019.105249

M3 - Article

C2 - 31678122

VL - 202

SP - 105249

JO - Acta Tropica

JF - Acta Tropica

SN - 0001-706X

ER -