• Obstetrics and gynecology · Mar 2011

    Breast milk hydrocodone and hydromorphone levels in mothers using hydrocodone for postpartum pain.

    • Jason B Sauberan, Philip O Anderson, James R Lane, Sally Rafie, Nancy Nguyen, Steven S Rossi, and Lisa M Stellwagen.
    • Department of Pharmacy and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego Medical Center, San Diego, California 92103-8765, USA. jsauberan@ucsd.edu
    • Obstet Gynecol. 2011 Mar 1; 117 (3): 611-7.

    ObjectiveTo estimate the extent of passage of hydrocodone and its active metabolite, hydromorphone, into breast milk.MethodsThis is a pharmacokinetic study of 30 postpartum women receiving hydrocodone bitartrate for postpartum pain in the inpatient setting. Mothers donated timed breast milk samples for the analysis of hydrocodone and hydromorphone.ResultsFully breastfed neonates received 1.6% (range 0.2%-9%) of the maternal weight-adjusted hydrocodone bitartrate dosage. When combined with hydromorphone, the total median opiate dosage from breast milk is 0.7% of a therapeutic dosage for older infants. Most mothers excreted little to no hydromorphone into breast milk.ConclusionStandard postpartum dosages of hydrocodone bitartrate appear to be acceptable to use in women nursing newborns. Prolonged use of high dosages is not advisable.

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