Last update: May 1, 2019

双氯芬酸

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). Indicated in rheumatic diseases, gout, dysmenorrhea, adnexitis, and post-traumatic or post-operative pain and inflammation.
Oral administration in two to three daily doses.

Its pharmacokinetic data (high percentage of protein binding and short half-life) explain the zero or miniscule transfer into breastmilk observed:
The drug is excreted in milk in insignificant or undetectable quantities (AEMPS 2017, Sandoz 2017, Hale 2017 p.277, Hutchinson 2013, Worthington 2013, ABM 2012, Østensen 2007, Sioufi 1982).

No adverse effects have been detected in breastfed babies whose mothers were taking it (Yefet 2017, Davanzo 2014, Hutchinson 2013, Hirose 1996).

For all these reasons it is considered compatible with breastfeeding (Yefet 2017, Davanzo 2014, Hutchinson 2013, Amir 2011, Lee 1993, Brooks 1990, Goldsmith 1989, Needs 1985).

Most non-steroidal anti-inflammatories can increase jaundice, so it is preferable to avoid them during the neonatal period in mothers of jaundiced infants. (Janssen 2000).

TOPICAL USE:
The small dose and poor plasma uptake of most topical dermatological or ophthalmological preparations make it very unlikely that significant amounts will pass into breast milk.
Ophthalmic or dermatological use is completely compatible with breastfeeding.

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

双氯芬酸 is Diclofenac in Chinese.

Is written in other languages:

双氯芬酸 is also known as

Tradenames

Main tradenames from several countries containing 双氯芬酸 in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 318 daltons
Protein Binding 100 %
VD 0,6 l/Kg
Tmax 1 - 2 hours
T1/2 1 - 2 hours
Theoretical Dose 0,00075 - 0,015 mg/Kg/d
Relative Dose 0,03 - 0,9 %
Relat.Ped.Dose 0,025 - 3 %

References

  1. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  2. AEMPS. Diclofenaco Ficha técnica. 2017 Full text (in our servers)
  3. Sandoz. Diclofenac. Data Sheet. 2017 Full text (in our servers)
  4. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. 11th edition (acces on line) 2017
  5. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014 Abstract
  6. Hutchinson S, Marmura MJ, Calhoun A, Lucas S, Silberstein S, Peterlin BL. Use of common migraine treatments in breast-feeding women: a summary of recommendations. Headache. 2013 Abstract Full text (link to original source) Full text (in our servers)
  7. Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ; Canadian Headache Society Acute Migraine Treatment Guideline Development Group. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013 Abstract Full text (in our servers)
  8. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Abstract Full text (link to original source) Full text (in our servers)
  9. Østensen M, Motta M. Therapy insight: the use of antirheumatic drugs during nursing. Nat Clin Pract Rheumatol. 2007 Abstract
  10. Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Arch Intern Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  11. Hirose M, Hara Y, Hosokawa T, Tanaka Y. The effect of postoperative analgesia with continuous epidural bupivacaine after cesarean section on the amount of breast feeding and infant weight gain. Anesth Analg. 1996 Abstract
  12. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  13. Brooks PM, Needs CJ. Antirheumatic drugs in pregnancy and lactation. Baillieres Clin Rheumatol. 1990 Abstract
  14. Goldsmith DP. Neonatal rheumatic disorders. View of the pediatrician. Rheum Dis Clin North Am. 1989 Abstract
  15. Needs CJ, Brooks PM. Antirheumatic medication during lactation. Br J Rheumatol. 1985 Abstract
  16. Sioufi A, Stierlin H, Schweizer A et al. Recent findings concerning clinically relevant pharmacokinetics of diclofenac sodium. Kass E. Voltaren new findings. Bern: Hans Huber Publishers, 1982:19-30. 1982

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