Tocainide was removed from the market in the United States in 2003 because it can cause serious and potentially fatal hematological adverse effects. Limited data indicate that rather large amounts of tocainide are excreted into breastmilk. Because of the relative lack of data concerning breastfeeding during maternal tocainide therapy and is potential toxicity, tocainide should be avoided during breastfeeding.
Drug Levels
Maternal Levels. One woman taking tocainide 400 mg every 8 hours orally during the early postpartum period had levels of 12 mg/L at 0.5 hour before a dose and 28 mg/L at 2 hours after a dose.[1] These data indicate that an exclusively breastfed infant would receive between 9 and 21% of the maternal weight-adjusted dosage.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
References
1.
Wilson JH. Breast milk tocainide levels. J Cardiovasc Pharmacol 1988;12:497 [PubMed: 2465453]
Substance Identification
Substance Name
Tocainide
CAS Registry Number
41708-72-9
Drug Class
Breast Feeding
Lactation
Milk, Human
Antiarrhythmics
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