哺乳期女性服用洛匹那韦/利托那韦对乳儿影响的研究进展

doi:10.19803/j.1672-8629.2022.03.14

摘要/Abstract

摘要： 洛匹那韦/利托那韦是国内批准用于治疗人类免疫缺陷病毒（HIV）感染的药物,在目前国内新型冠状病毒肺炎治疗中,也被多版指南列为有效的抗病毒药物。对于已经确诊的新型冠状病毒肺炎的产妇,在哺乳期将面临抗病毒药物选择的问题。通过检索国内外数据库文献,从洛匹那韦/利托那韦的药代动力学、真实世界中洛匹那韦/利托那韦在乳汁和乳儿体内的浓度、对乳儿的影响,以及一部分婴幼儿使用洛匹那韦/利托那韦的证据,对服用洛匹那韦/利托那韦哺乳期女性的乳儿安全性进行阐述。洛匹那韦/利托那韦是对哺乳期女性乳儿安全性较高的一种抗病毒药物,该药对乳儿影响较小。如果需要在新型冠状病毒感染的哺乳期女性中使用洛匹那韦/利托那韦,在确保新型冠状病毒不会通过哺乳垂直传播的情况下,可以继续哺乳,并应关注乳儿血清钠、血清钾、胆固醇、甘油三酯、血糖、丙氨酸转氨酶及胰岛素的水平。

关键词: 洛匹那韦/利托那韦, 新型冠状病毒, 乳儿, 安全性, 人类免疫缺陷病毒

Abstract: Lopinavir / ritonavir has been approved for the treatment of human immunodeficiency virus (HIV) infection in China. It is also listed as an effective antiviral drug amid the COVID-19 pandemic in China. Lactating women infected with COVID-19 will have to face the problem of which antiviral drugs should be selected during lactation. This paper was intended to summarize the pharmacokinetics of lopinavir / ritonavir, the concentrations of lopinavir / ritonavir in breast milk and in sucklings in the real world, the effect on sucklings, and the evidence related to the use of lopinavir / ritonavir in some infants. Lopinavir / ritonavir is a quite safe antiviral drug for lactating women, and its effect on sucklings is very small. If lopinavir / ritonavir has to be used in lactating women infected with the COVID-19 virus, suckling can be continued as long as the virus will not be transmitted vertically through suckling. The levels of serum sodium, serum potassium, cholesterol, triglyceride, blood glucose, alanine transaminase and insulin in sucklings should be monitored.

Key words: lopinavir / litonavir, COVID-19, sucklings, safety, HIV

中图分类号:

R994.11

周博雅, 袁偲偲, 冯欣. 哺乳期女性服用洛匹那韦/利托那韦对乳儿影响的研究进展[J]. 中国药物警戒, 2022, 19(3): 296-301.

ZHOU Boya, YUAN Sisi, FENG Xin. Research progress in effects of lopinavir / ritonavir used by lactating females on sucklings[J]. Chinese Journal of Pharmacovigilance, 2022, 19(3): 296-301.

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