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Journal of Glaucoma:
June/July 2008 - Volume 17 - Issue 4 - pp 329-331
doi: 10.1097/IJG.0b013e31815c3a5b
Case Report

Timolol Concentrations in Breast Milk of a Woman Treated for Glaucoma: Calculation of Neonatal Exposure

Madadi, Parvaz BMSc* †; Koren, Gideon MD† ‡; Freeman, David J. PhD§; Oertel, Reinhard PhD∥; Campbell, Robert J. MD, MSc¶; Trope, Graham E. MB, PhD♯

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Abstract

A 32-year-old lactating woman with open-angle glaucoma used timolol maleate 0.5% eye drops twice daily to her right eye for 6 months. Four milk samples were collected over a span of 6 days. Timolol maleate milk levels were examined by liquid chromatography tandem mass spectrometry and found to be at a mean of 0.12 ng/mL (range, 0 to 0.37 ng/mL). At this level, the theoretical maximum relative infant dose expressed as a percentage of the weight-adjusted maternal dose was 0.012%. As most glaucoma patients administer drops to both eyes, the dosage was duplicated to reflect the more pertinent calculated theoretical relative infant dose of 0.024%. This dose of timolol is unlikely to cause systemic side effects to the healthy breastfed infant.

© 2008 Lippincott Williams & Wilkins, Inc.

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