ATENOLOL LACTATION STUDY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. High blood pressure is a common condition in pregnant women. Atenolol is an effective agent for the management of high blood pressure during and after pregnancy. We recently completed a study evaluating the pharmacokinetics of atenolol in pregnancy. However, no one has studied the pharmacokinetics of atenolol postpartum. Product labeling for atenolol states that "Atenolol is excreted in human breast milk at a ratio of 1.5 to 6.8 when compared to the concentration in plasma. Caution should be exercised when atenolol is administered to a nursing woman. Clinically significant bradycardia has been reported in breast fed infants. Premature infants, or infants with impaired renal function, may be more likely to develop adverse effects." Despite this warning, many women receiving atenolol for hypertension decide to breastfeed their infants. Because of the multiple health benefits for infants, exclusive breastfeeding for the first 6 months of life is recommended by the American Academy of Pediatrics and the World Health Organization. This study is designed to evaluate the pharmacokinetics of atenolol in plasma, urine and breast milk 2-4 weeks, 3-4 months and 6-8 months postpartum in women taking atenolol for therapeutic reasons and nursing their infants.