Last update July 10, 2023
Ketamine is a fast-acting general anesthetic used for the induction of anesthesia, usually in combination with a muscle relaxant. Intravenous administration. It is also used as a recreational drug of abuse because of its dissociative effects orally, inhaled, intravenously, intramuscularly or rectally. (NIH 2023, Royo 2004)
Since the last update we have not found published data on its excretion in breastmilk.
It is excreted in breast milk in clinically insignificant amounts (Wolfson 2022).
Its low oral bioavailability minimizes the passage into infant plasma from ingested breast milk.
No problems have been seen in infants whose mothers were treated with ketamine. (Gilder 2021, Ortega 1999)
The use of S-ketamine or Ketamine as post-caesarean analgesia did not affect the duration of breastfeeding (Suppa 2012) and shortened the time to first breastfeeding. (Jaafarpour 2017)
t may be a cause of hallucinatory/psychotic reactions in the mother within the next 24 hours after usage: close follow-up is mandatory. (Pfizer 2020, Vallersnes 2016, Sandoz 2015, OMS 2003)
Several medical societies and expert authors consider the use of this medication possible during breastfeeding. (Howie 2006, WHO 2002)
Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable (Reece 2017), especially during the neonatal period and in the event of prematurity.
It should not be used as a drug of abuse during lactation. It is recommended to wait to breastfeed 15 hours (5 ½ T) after the last recreational use. There is no scientific evidence on the benefits and risks of microdosing of psychedelic/disociative drugs. (NIH 2023, Kaypak 2022, de Wit 2022, Szigeti 2021, Lea 2020, Kuypers 2019)
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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