Excretion of Quazepam Into Human Breast Milk

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Abstract
Previous metabolic studies have established that two major metabolites, 2‐oxoquazepam and N‐desalkyl‐2‐oxoquazepam, are present in plasma after dosing with quazepam, a new benzodiazepine hypnotic. The excretion of quazepam, 2‐oxoquazepam, and N‐desalkyl‐2‐oxoquazepam into human breast milk was studied in four lactating nonpregnant volunteers. Each volunteer received one 15‐mg quazepam tablet following an overnight fast. Nursing of offspring was discontinued after drug administration. Milk and blood samples were collected prior to and at specified times (up to 48 hours) after dosing. Plasma and milk levels of quazepam, 2‐oxoquazepam, and N‐desalkyl‐2‐oxoquazepam were determined by specific GLC methods. The concentrations of the three compounds found in milk appeared to depend on their relative lipophilicities, which were determined by log P values. The mean milk/plasma AUC ratios of quazepam, 2‐oxoquazepam, and N‐desalkyl‐2‐oxoquazepam were 4.19, 2.02, and 0.091, respectively. Levels of quazepam and 2‐oxoquazepam declined at about the same rate in plasma and in milk. The total amount of the administered quazepam dose found in the milk as quazepam, 2‐oxoquazepam, and N‐desalkyl‐2‐oxoquazepam through 48 hours was only 0.11 per cent.

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