Last update Nov. 6, 2022
Limited compatibility
We do not have alternatives for Lapatinib Tosilate / Ditosylate.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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Lapatinib Tosilate / Ditosylate in other languages or writings:
Lapatinib Tosilate / Ditosylate belongs to these groups or families:
Variable | Value | Unit |
---|---|---|
Oral Bioavail. | baja / poor | % |
Molecular weight | 944 | daltons |
Protein Binding | > 99 | % |
VD | 31 | l/Kg |
pKa | 16.44 | - |
Tmax | 4 | hours |
T½ | 14 - 24 | hours |
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e-lactancia is a resource recommended by La Liga de la Leche, España of Spain
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It is a dual tyrosine kinase inhibitor directed against two human epidermal growth factor receptors. It is used in the treatment of some types of breast cancer, associated with capecitabine or with an aromatase inhibitor. Oral administration once daily.
Since the last update we have not found published data on its excretion in breastmilk.
Its pharmacokinetic characteristics (very high plasma protein binding, very large volume of distribution and elevated molecular weight) make it very unlikely its excretion into breast milk in significant amounts.
Although oral bioavailability is low, it is greatly increased when administered with food, so it could have a systemic action in the infant.
The most common side effects of the drug are gastrointestinal disorders (diarrhoea), dermatological reactions and fatigue.
It is known from pharmacokinetics that after 3 elimination half-lives (T½) 87.5% of the drug is eliminated from the body; after 4 T½ it is 94%, after 5 T½, 96.9%, after 6 T½, 98.4% and after 7 T½ it is 99%. From 7 T½ the plasma concentrations of the drug in the body are negligible. In general, a period of at least five half-lives can be considered a safe waiting period before breastfeeding again.(Anderson 2016).
Taking the longest T½ published as a reference (24 hours), these 5 T½ would correspond to 120 hours (5 days). Meanwhile, express and discard milk from the breast regularly. This does not allow breastfeeding during treatment.
Abrupt weaning can be psychologically traumatic for both the mother and the infant. (Pistilli 2013).
If used during lactation, it is advisable to monitor growth and appetite and the possible appearance of diarrhea in the infant, as well as monitor liver function periodically.
Given the strong evidence that exists regarding the benefits of breastfeeding for the development of babies and the health of mothers, it is advisable to evaluate the risk-benefit of any maternal treatment, including chemotherapy, individually advising each mother who wishes to continue with breastfeeding. (Koren 2013)
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