Last update Aug. 16, 2022

C21H29NO2,C4H6O6

Compatible

Safe substance and/or breastfeeding is the best option.

It is a potent opioid agonist-antagonist analgesic used for the relief of moderate to severe pain, including labor pain, and as an adjunct to anesthesia. Administration by intravenous, intramuscular, or intranasal routes.

It is excreted in breast milk in negligible amount. (Pittman 1980)

The time of onset of breastfeeding was delayed in newborns whose mothers received analgesia at delivery with butorphanol or nalbuphine compared to those who did not receive analgesia, although in both groups it occurred on average within the first hour after birth. (Crowell 1994)

Expert authors consider the use of this medication during lactation to be probably compatible. (Hale, Reece 2017, Briggs 2015, Sachs 2013). American Academy of Pediatrics: medication usually compatible with breastfeeding.(AAP 2001)

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable, especially during the neonatal period and in the event of prematurity.

Alternatives

  • Ibuprofen (Safe substance and/or breastfeeding is the best option.)
  • Paracetamol (Safe substance and/or breastfeeding is the best option.)

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

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Other names

C21H29NO2,C4H6O6 is Butorphanol Tartrate in Molecular formula.

Is written in other languages:

Group

C21H29NO2,C4H6O6 belongs to this group or family:

Tradenames

Main tradenames from several countries containing C21H29NO2,C4H6O6 in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 5 - 17 %
Molecular weight 478 daltons
Protein Binding 80 %
VD 4.4 - 12.9 l/Kg
Tmax 0.3 - 0.7 hours
T½ 4.6 hours
M/P ratio 0.7 - 1.9 -
Theoretical Dose 0.0001 - 0.0006 mg/Kg/d
Relative Dose 0.1 - 0.5 %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  2. 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)
  3. 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
  4. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  5. OMS. Comité de Expertos de la OMS en Farmacodependencia. Examen crítico de psicofármacos. OMS. Serie de informes técnicos, 33 informe. 2003 Full text (in our servers)
  6. WHO Expert Committee on Drug Dependence. Critical review of psychoactive substances. WHO Technical Report Series. Thirty-third Report 2003 Full text (link to original source) Full text (in our servers)
  7. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  8. Crowell MK, Hill PD, Humenick SS. Relationship between obstetric analgesia and time of effective breast feeding. J Nurse Midwifery. 1994 May-Jun;39(3):150-6. Abstract
  9. Pittman KA, Smyth RD, Losada M, Zighelboim I, Maduska AL, Sunshine A. Human perinatal distribution of butorphanol. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 1):797-800. Abstract

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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2015 of United States of America

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