title: Passage of irinotecan and its active metabolite, SN-38, into human milk.
abstract: OBJECTIVE
  We measured the levels of irinotecan and its active metabolite, SN-38, in human milk after the administration of irinotecan to assess the potential risks when women treated with irinotecan nurse their infants.
  
  
  METHODS
  Human milk was collected for 6 days starting on the day after irinotecan was administered. The levels of irinotecan and SN-38 in human milk were measured using liquid chromatography-mass spectrometry. Irinotecan was detected on Days 2 and 3 but not after Day 4. A strong signal indicating the presence of SN-38 was detected on Day 2 and the signal was readily detected until Day 7, indicating that SN-38 remained in human milk.
  
  
  CONCLUSIONS
  Intravenously administered CPT-11 continues to pass into human milk over a prolonged period in the form of its active metabolite, SN-38. The relationship between administration of CPT-11 and SN-38 exposure and toxicity is still not well defined, so patients should avoid nursing their infants while they are being treated with CPT-11.
authors.affiliation: Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Nakagawa
authors.affiliation: Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Terui
authors.affiliation: Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hosoi
authors.affiliation: Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ueno
authors.affiliation: Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hayakari
mesh_terms: D000328:Adult; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000378:metabolism; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008895:Milk, Human / Q000378:metabolism*
chemical_list: D000077146:Irinotecan; D002166:Camptothecin
keywords: SN-38; human milk; infant; irinotecan; lactation