toxylact: a07aa07 amphotericin b

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A07AA07 comprises oral amphotericin B, a polyene antifungal antibiotic used as a non‑absorbed intestinal antimycotic; oral amphotericin B is generally compatible with breastfeeding because systemic maternal exposure and milk transfer are expected to be minimal at usual doses.atcddd.fhi+4

Drug and ATC classification

Amphotericin B is a macrolide polyene antifungal antibiotic produced by Streptomyces nodosus and used to treat potentially life‑threatening fungal infections and certain protozoal diseases such as leishmaniasis.wikipedia+3
In the ATC system, oral amphotericin B used as an intestinal antiinfective is classified as A07AA07 within the A07AA subgroup (intestinal antibiotics/antimycotics).atcddd.fhi+5
Oral preparations (e.g. suspensions or tablets) are licensed mainly for prophylaxis and treatment of candidiasis in the gastrointestinal tract and for Candida infections in the oropharynx, where the drug acts locally in the lumen.gelbe-liste+1

Pharmacology and toxicology

Amphotericin B binds to ergosterol in fungal cell membranes, increasing membrane permeability and causing leakage of intracellular components, which leads to fungistatic or fungicidal effects depending on concentration and organism.drugbank+4
The oral intestinal formulation is poorly absorbed from the gastrointestinal tract, so most of the administered dose remains in the lumen and is excreted in the feces; it is not suitable for systemic fungal infections, which require intravenous therapy.drugcentral+1
Systemic amphotericin B (parenteral) is associated with significant nephrotoxicity, infusion‑related reactions, and electrolyte disturbances, but these toxicities are largely related to high systemic exposure and are not expected with standard oral intestinal treatment.pubmed.ncbi.nlm.nih+2

Use in lactation

Poorly absorbed intestinal antimycotics such as oral amphotericin B are typical examples of medicines with very low maternal plasma concentrations and therefore minimal transfer into breast milk.ncbi.nlm.nih+1
Given the lack of significant systemic absorption, milk levels of amphotericin B after oral intestinal use are expected to be extremely low, and clinically relevant exposure of the breastfed infant is unlikely.drugcentral+1
Consequently, oral A07AA07 amphotericin B is generally considered compatible with breastfeeding, and lactation can usually continue without interruption, while the infant is observed for nonspecific gastrointestinal symptoms such as nausea, vomiting, or altered stool pattern.ncbi.nlm.nih+3

Clinical considerations in breastfeeding women

Clinicians should confirm that the product used in a breastfeeding woman is an oral intestinal formulation (A07AA07) and not a systemic intravenous amphotericin B preparation, since systemic therapy carries a substantially higher risk of nephrotoxicity and other serious adverse effects.atcddd.fhi+3
Usual lactation‑pharmacology precautions apply: use the lowest effective dose for the shortest necessary duration, consider maternal renal function, and avoid concomitant nephrotoxic agents if there is any possibility of systemic exposure.pubmed.ncbi.nlm.nih+2
Major breastfeeding guidance documents emphasize that most maternal medications, including many antimicrobials, are not absolute contraindications to breastfeeding, and decisions should be based on individual risk–benefit assessment with reference to specialized lactation resources

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