Last update Aug. 9, 2022

Hydrocodone Hydrochloride

Low Risk

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

Narcotic opioid structurally related to codeine most commonly used for the treatment of cough and pain. It is metabolized to hydromorphone. Administered orally every 4 to 6 hours. The cytochrome P450-2D6 enzyme catalyzes codeine to morphine.

Excreted in clinically insignificant amounts through breast milk. (Sauberan 2011, Anderson 2007)

Drowsiness was reported in an infant less than a month old whose mother was taking 120 mg of hydrocodone daily (Bodley 1997) and apnea in a 5-week-old infant whose mother was taking hydrocodone and methadone simultaneously. (Meyer 2005)

Discontinue use at the sign of maternal or infant excessive sedation and do not administer if there is prior history of maternal or familiar excessive sedation. From 1% to 29% of people have an accelerated metabolic conversion rate of codeine to morphine due to a genetic excess of the P450-2D6 enzyme.

It is recommended not to exceed doses above 30 mg of hydrocodone a day for the treatment of postpartum pain. (Sauberan 2011)

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable (Lamvu 2018, Rowe 2013)especially during the neonatal period and in the event of prematurity.

After intravenous use of opioids during surgery, it is considered safe to resume breastfeeding once the mother is awake and fit. (Reece 2017)


See below the information of this related product:

  • Codeine ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)

Alternatives

  • Buprenorphine Hydrochloride ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Butorphanol Tartrate ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Dexibuprofen ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Morphine (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Nalbuphine Hydrochloride ( 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

Hydrocodone Hydrochloride is also known as


Hydrocodone Hydrochloride in other languages or writings:

Groups

Hydrocodone Hydrochloride belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Hydrocodone Hydrochloride in its composition:

  • Aseptobron Unicap™. Contains other elements than Hydrocodone Hydrochloride in its composition
  • Atuss
  • Caldomine
  • Codamine
  • Dalmacol™. Contains other elements than Hydrocodone Hydrochloride in its composition
  • Hycodan
  • Hycomine
  • Hysingla
  • Nalex DH™. Contains other elements than Hydrocodone Hydrochloride in its composition
  • Novahistex DH™. Contains other elements than Hydrocodone Hydrochloride in its composition
  • Tussplex™. Contains other elements than Hydrocodone Hydrochloride in its composition

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 299 daltons
Tmax 1.3 hours
3.8 hours
Theoretical Dose 0.002 - 0.004 mg/Kg/d
Relative Dose 1.6 - 3.7 %

References

  1. Lamvu G, Feranec J, Blanton E. Perioperative pain management: an update for obstetrician-gynecologists. Am J Obstet Gynecol. 2018 Feb;218(2):193-199. Abstract
  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. Dalal PG, Bosak J, Berlin C. Safety of the breast-feeding infant after maternal anesthesia. Paediatr Anaesth. 2014 Abstract
  4. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  5. Sauberan JB, Anderson PO, Lane JR, Rafie S, Nguyen N, Rossi SS, Stellwagen LM. Breast milk hydrocodone and hydromorphone levels in mothers using hydrocodone for postpartum pain. Obstet Gynecol. 2011 Abstract
  6. Anderson PO, Sauberan JB, Lane JR, Rossi SS. Hydrocodone excretion into breast milk: the first two reported cases. Breastfeed Med. 2007 Abstract
  7. Meyer D, Tobias JD. Adverse effects following the inadvertent administration of opioids to infants and children. Clin Pediatr (Phila). 2005 Jul-Aug;44(6):499-503. Abstract
  8. Bodley V, Powers D. Long-term treatment of a breastfeeding mother with fluconazole-resolved nipple pain caused by yeast: a case study. J Hum Lact. 1997 Abstract

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