Questions about Rheumatoid Arthritis? Get answers from our expert.

Prednisone Pregnancy and Breastfeeding Warnings

Prednisone is also known as: Deltasone, Liquid Pred, Meticorten, Orasone, Prednicen-M, Prednicot, Rayos, Sterapred, Sterapred DS

Prednisone Pregnancy Warnings

Prednisone has not been formally assigned to a pregnancy category by the FDA. However, its active metabolite, prednisoLONE, has been assigned to pregnancy category C by the FDA. Some animal studies have revealed evidence of fetal harm, although data are conflicting. There are no controlled data in human pregnancy. Prednisone is only recommended for use during pregnancy when there are no alternatives and benefit outweighs risk.

In the Michigan Medicaid Birth Defects Study involving 229,101 pregnancies from 1985 to 1992, there were 143 first trimester exposures to prednisolone (written communication, Franz Rosa, MD, Food and Drug Administration, 1994). A statistically significant increase in the total number of birth defects was found, with eleven cases reported compared with only six cases expected. However, no association between prednisolone and the six categories of defects studied (cardiovascular, oral clefts, spina bifida, polydactylies, limb reduction defects/syndactylies, hypospadias) was found.

Prednisone Breastfeeding Warnings

In one study of six lactating women, prednisolone milk concentrations were 5% to 25% of corresponding serum concentrations. The authors estimated that a nursing infant would be exposed to negligible amounts of drug with maternal doses of 20 to 40 mg per day. The excretion of prednisolone into breast milk has been evaluated in six women on chronic prednisolone therapy. Milk prednisolone concentrations ranged from less than 10 to 106 ng/mL in patients receiving 10 mg to 45 mg per day (N=5). In a patient receiving 80 mg per day, milk prednisolone concentrations ranged from less than 10 ng/mL prior to the morning dose to 317 ng/mL at one hour post-dose. The peak milk to plasma concentration ratio ranged from 0.12 to 0.25. The authors recommend that nursing be withheld for four hours after administration of doses greater than 20 mg. In a recent study, prednisolone excretion into breast milk was evaluated in three women following administration of prednisolone phosphate 50 mg intravenously one time. During the six-hour study period, 0.010% to 0.049% of the administered dose of prednisolone was recovered in breast milk. Nursing infants would be expected to experience minimal exposure. Data from this study also suggest that exchange of unbound prednisolone between breast milk and serum is rapid and bi-directional.

Prednisone and its active metabolite prednisolone are excreted into human milk in small amounts. Animal studies have revealed an increased incidence of cleft palate in offspring. In one study of six lactating women, prednisolone milk concentrations were 5% to 25% of corresponding serum concentrations. The authors estimated that a nursing infant would be exposed to negligible amounts of drug with maternal doses of 20 to 40 mg per day. The excretion of prednisolone into breast milk has been evaluated in six women on chronic prednisolone therapy. Milk prednisolone concentrations ranged from less than 10 to 106 ng/mL in patients receiving 10 mg to 45 mg per day (N=5). In a patient receiving 80 mg per day, milk prednisolone concentrations ranged from less than 10 ng/mL prior to the morning dose to 317 ng/mL at one hour post-dose. The peak milk to plasma concentration ratio ranged from 0.12 to 0.25. The authors recommend that nursing be withheld for four hours after administration of doses greater than 20 mg. In a recent study, prednisolone excretion into breast milk was evaluated in three women following administration of prednisolone phosphate 50 mg intravenously one time. During the six-hour study period, 0.010% to 0.049% of the administered dose of prednisolone was recovered in breast milk. Nursing infants would be expected to experience minimal exposure. Data from this study also suggest that exchange of unbound prednisolone between breast milk and serum is rapid and bi-directional. Prednisone is considered compatible with breast-feeding by the American Academy of Pediatrics. The manufacturer recommends that caution be used when administering prednisone to nursing women.

See Also...

Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Wolters Kluwer Health and Drugs.com is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2008 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide
(web4)