Last update Aug. 3, 2022
Very Low Risk
Buprenorphine is an opioid analgesic, partial opioid agonist, used for relief of moderate to severe pain and as an adjunct to anesthesia. It is also used in the maintenance treatment of opioid dependence. Intramuscular, intravenous, sublingual or subdermal implant administration.
It is excreted in breast milk in clinically insignificant amount. (Jansson 2016, Swortwood 2016, Ilett 2012, Lindemalm 2009, Grimm 2005, Johnson 2001, Marquet 1997)
No problems have been observed in infants whose mothers have taken it. (Gower 2014, Ilett 2012, Johnson 2001, Marquet 1997)
Plasma or urinary levels in these infants were very low or undetectable. (Jansson 2016, Swortwood 2016, Lindemalm 2009)
Extradural buprenorphine after cesarean section decreased breast milk production and infant weight gain. (Hirose 1997)
It has been noticed a mild abstinence syndrome after birth when sudden withdrawn occurred. (Elladki 2011). Gradual weaning from breastfeeding is advised (Kocherlakota 2014). Breastfeeding reduces the need for withdrawal treatment in opioid-exposed infants during pregnancy (Wong 2018, Wachman 2017, Short 2016, Welle 2013, O'Connor 2013), although not always with significant differences. (Welle 2013, O'Connor 2013)
There are studies that find a higher frequency of breastfeeding with buprenorphine than with methadone (Yonke 2019). In others, the frequency of breastfeeding was similar and very low in mothers treated for opioid dependence with methadone or buprenorphine. (Wachman 2010, Lejeune 2001)
Several medical societies and experts authors consider the use of this medication to be safe or very probably safe during breastfeeding. (Committee 2017, ABM 2015, Bagley 2014, Kocherlakota 2014, Sachs 2013, Wong 2011)
We do not have alternatives for Buprenorphine Hydrochloride since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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Thank you for helping to protect and promote breastfeeding.
e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2012 of United States of America
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM