Last update Aug. 9, 2022
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)
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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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2006 of United States of America
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