Last update July 30, 2022


Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Opioid analgesic related to fentanyl used in the induction and maintenance of general anesthesia, in postoperative analgesia and in local or regional anesthesia. intravenous administration.

Since the last update we have not found published data on its excretion in breastmilk.

Although its pharmacokinetic data (low molecular weight, low protein binding, high lipid solubility and low volume of distribution) make easy the passage into breast milk, its very short half-life (less than 10 minutes) makes its excretion in breast milk unlikely.  

No problems have been observed in breastfed infants aged 3 to 5 months whose mothers received remifentanil, propofol, rocuronium, and xenon for anesthesia for surgical procedures. (Stuttman 2010)

There were no significant differences in breastfeeding initiation, continuation, or problems between the groups of mothers treated with pethidine, meperidine, or remifentanil. (Moran 2019, Evron 2005)

The mother may breastfeed the baby as soon as she is recovered from anesthesia. No need to express and discard breast milk. (Reece 2017)


Expert authors consider the use of this medication to be probably safe during breastfeeding. (Hale, LactMed, Briggs 2015, Schaefer 2015, Howie 2006)


  • Fentanyl ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Ibuprofen ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Paracetamol ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

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.

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

C20H28N2O5,HCl is Remifentanil Hydrochloride in Molecular formula.

Is written in other languages:


C20H28N2O5,HCl belongs to this group or family:


Main tradenames from several countries containing C20H28N2O5,HCl in its composition:


Variable Value Unit
Oral Bioavail. Baja / Low %
Molecular weight 413 daltons
Protein Binding 70 %
VD 0.005 l/Kg
0.05 - 0.17 hours


  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from Consulted on April 10, 2024 Full text (link to original source)
  3. Moran VH, Thomson G, Cook J, Storey H, Beeson L, MacArthur C, Wilson M. Qualitative exploration of women's experiences of intramuscular pethidine or remifentanil patient-controlled analgesia for labour pain. BMJ Open. 2019 Dec 23;9(12):e032203. Abstract Full text (link to original source)
  4. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  5. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  6. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  7. Dalal PG, Bosak J, Berlin C. Safety of the breast-feeding infant after maternal anesthesia. Paediatr Anaesth. 2014 Abstract
  8. Reynolds F. Labour analgesia and the baby: good news is no news. Int J Obstet Anesth. 2011 Abstract
  9. Stuttmann R, Schäfer C, Hilbert P, Meyer MR, Maurer HH. The breast feeding mother and xenon anaesthesia: four case reports. Breast feeding and xenon anaesthesia. BMC Anesthesiol. 2010 Abstract Full text (link to original source) Full text (in our servers)
  10. Howie WO, McMullen PC. Breastfeeding problems following anesthetic administration. J Perinat Educ. 2006 Abstract Full text (link to original source) Full text (in our servers)
  11. Evron S, Glezerman M, Sadan O, Boaz M, Ezri T. Remifentanil: a novel systemic analgesic for labor pain. Anesth Analg. 2005 Jan;100(1):233-238. Abstract

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