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

Author(s): Sauberan JB, Anderson PO, Lane JR, Rafie S, Nguyen N, Rossi SS, Stellwagen LM

Affiliation(s): 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

Publication date & source: 2011-03, Obstet Gynecol., 117(3):611-7.

Publication type: Research Support, Non-U.S. Gov't

OBJECTIVE: To estimate the extent of passage of hydrocodone and its active metabolite, hydromorphone, into breast milk. METHODS: This 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. RESULTS: Fully 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. CONCLUSION: Standard postpartum dosages of hydrocodone bitartrate appear to be acceptable to use in women nursing newborns. Prolonged use of high dosages is not advisable.