Last update Aug. 10, 2022

N02AA11

High Risk

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

It is a potent (8-10 times more powerful than morphine) narcotic analgesic used in the management of moderate to severe pain. It is the active metabolite, and 14 times more potent, of oxycodone (Dalal 2014). Very often used for treatment of pain associated to episiotomy or Cesarean section operation. Oral, subcutaneous or intramuscular administration.

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

Its pharmacokinetic data (low molecular weight and low percentage of plasma protein binding) makes it likely that significant amounts will pass into breast milk.

On the other hand, its null oral bioavailability makes it difficult for it to pass to the infant plasma from ingested breast milk, except in premature infants and in the immediate neonatal period in which there may be greater intestinal permeability.

Women with some variants of enzyme-linked gene CYP2D6 who are on Oxycodone and their breastfed infants may experience increased sedation. (van den Anker 2012)

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.

Overall, the use of opioids for pain control during labor and another 3 days is compatible with breastfeeding. The duration of opioid treatment should be limited to 3 days in unsupervised outpatient settings. (Ito 2018). Adequately use of nonsteroidal anti-inflammatory drugs (NSAIDs) may attain pain relief with less side effects than with narcotic analgesics.

Alternatives

  • Buprenorphine Hydrochloride ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Butorphanol Tartrate ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Ibuprofen ( 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.

Group

N02AA11 belongs to this group or family:

Tradenames

Main tradenames from several countries containing N02AA11 in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 10 %
Molecular weight 338 daltons
Protein Binding 12 %
pKa 10.07 -
Tmax 1.9 hours
1.3 ± 0.7 hours

References

  1. Ito S. Opioids in Breast Milk: Pharmacokinetic Principles and Clinical Implications. J Clin Pharmacol. 2018 Oct;58 Suppl 10:S151-S163. Abstract
  2. Dalal PG, Bosak J, Berlin C. Safety of the breast-feeding infant after maternal anesthesia. Paediatr Anaesth. 2014 Abstract
  3. van den Anker JN. Is it safe to use opioids for obstetric pain while breastfeeding? J Pediatr. 2012 Abstract Full text (in our servers)

Total visits

517

Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write us at elactancia.org@gmail.com

e-lactancia is a resource recommended by Confederación Nacional de Pediatría (CONAPEME) of Mexico

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM