Last update July 9, 2022

Propofol

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

It is a short-acting anesthetic that is administered intravenously for the induction and maintenance of general anesthesia and for sedation. It is an authorized medication for use in infants older than 1 month.

Its pharmacokinetic data (high percentage of protein binding and very large volume of distribution) explain the negligible passage into colostrum or breast milk observed. (Stuttmann 2010, Birkholz 2009, Nitsun 2006, Dailland 1989, Schmitt 1987)

No side-effects were observed in breastfed infants of mothers who were administered this medication. (Stuttmann 2010)

Propofol causes a transient and brief increase in prolactin levels (Murakawa 1998). The use of Propofol and Ketamine as post-cesarean analgesia shortened the time of the first breast feeding. (Jaafarpour 2017)

Its null oral bioavailability makes it difficult for it to pass to the infant plasma from ingested breast milk. (Dailland 1989)

90 minutes after extubation, no amounts of propofol are detected in the milk (Stuttmann 2010). The mother may breastfeed the baby as soon as she is recovered from anesthesia. No need to express and discard breast milk. (Reece 2017, Schaefer 2015, ASGE 2012, Nitsun 2006, Dailland 1989)

Propofol can turn urine green. Cases of transient (1 to 4 days) green or bluish-green discoloration of breast milk have been reported after administration of propofol (Bulut 2021, Prescriber 2021, Rainone 2018, Birkholz 2009)A mother reported to us in 2020 that after sedation with propofol, the expressed milk had a bluish color. Possibly this is more frequent than what has been reported, since it is only observed when the mother expresses milk. It would not be necessary to discard this milk as the culture was negative and propofol was not found in the breastmilk. (Bulut 2021, Rainone 2018)

Several medical societies and expert authors consider the use of this medication possible during breastfeeding. (Hale, Briggs 2015, Howie 2006, Mahadevan 2006, Lee 1993)

Alternatives

We do not have alternatives for Propofol since it is relatively safe.

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

Propofol is also known as


Propofol in other languages or writings:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. ≈ 0 %
Molecular weight 178 daltons
Protein Binding 99 %
VD 60 l/Kg
pKa 10.98 -
Tmax 0.004 - 0.008 hours
0.2 - 1 (term: 31) hours
Theoretical Dose 0.1 - 4.91 mg/Kg/d
Relative Dose 0.005 (0.002 - 0.74) %
Ped.Relat.Dose 0.007 - 0.5 %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on March 17, 2022 Full text (link to original source)
  2. Prescriber Update. Green breast milk – related to propofol? Prescriber Update 2021; 42(1) March Full text (link to original source) Full text (in our servers)
  3. Bulut O, Ovali F. Green breast milk: A rare side effect of propofol. J Paediatr Child Health. 2021 Jan;57(1):153-154. Abstract
  4. Rainone A, Delucilla L, Elofer S, Bensimon L, Abittan G. Propofol-Induced Green Breast Milk: A Case Report. Can J Hosp Pharm. 2018 Nov-Dec;71(6):389-391. Epub 2018 Dec 31. No abstract available. Abstract Full text (link to original source)
  5. 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)
  6. Jaafarpour M, Vasigh A, Khajavikhan J, Khani A. Effect of Ketofol on Pain and Complication after Caesarean Delivery under Spinal Anaesthesia: A Randomized Double-blind Clinical Trial. J Clin Diagn Res. 2017 Mar;11(3):UC04-UC07. Abstract Full text (link to original source)
  7. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  8. 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
  9. AGA - American Association for the Study of Liver Diseases; American College of Gastroenterology; American Gastroenterological Association Institute; American Society for Gastrointestinal Endoscopy; Society for Gastroenterology Nurses and Associates, Vargo JJ, DeLegge MH, Feld AD, Gerstenberger PD, Kwo PY, Lightdale JR, Nuccio S, Rex DK, Schiller LR. Multisociety sedation curriculum for gastrointestinal endoscopy. Gastroenterology. 2012 Jul;143(1):e18-41. Abstract Full text (link to original source) Full text (in our servers)
  10. ASGE Standard of Practice Committee., Shergill AK, Ben-Menachem T, Chandrasekhara V, Chathadi K, Decker GA, Evans JA, Early DS, Fanelli RD, Fisher DA, Foley KQ, Fukami N, Hwang JH, Jain R, Jue TL, Khan KM, Lightdale J, Pasha SF, Sharaf RN, Dominitz JA, Cash BD. Guidelines for endoscopy in pregnant and lactating women. Gastrointest Endosc. 2012 Jul;76(1):18-24. Abstract Full text (link to original source) Full text (in our servers)
  11. Stuttmann R, Schäfer C, Hilbert P, Meyer MR, Maurer HH. The breast feeding mother and xenon anaesthesia: four case reports. Breast feeding and xenon anaesthesia. BMC Anesthesiol. 2010 Abstract Full text (link to original source) Full text (in our servers)
  12. Birkholz T, Eckardt G, Renner S, Irouschek A, Schmidt J. Green breast milk after propofol administration. Anesthesiology. 2009 Abstract Full text (link to original source)
  13. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  14. Nitsun M, Szokol JW, Saleh HJ, Murphy GS, Vender JS, Luong L, Raikoff K, Avram MJ. Pharmacokinetics of midazolam, propofol, and fentanyl transfer to human breast milk. Clin Pharmacol Ther. 2006 Abstract
  15. Howie WO, McMullen PC. Breastfeeding problems following anesthetic administration. J Perinat Educ. 2006 Abstract Full text (link to original source) Full text (in our servers)
  16. Murakawa T, Tsubo T, Kudo T, Kudo M, Matsuki A. [Effect of propofol as an agent for anesthetic induction on pituitary-adrenocortical function during anesthesia and surgery]. Masui. 1998 Abstract
  17. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  18. Dailland P, Cockshott ID, Lirzin JD, Jacquinot P, Jorrot JC, Devery J, Harmey JL, Conseiller C. Intravenous propofol during cesarean section: placental transfer, concentrations in breast milk, and neonatal effects. A preliminary study. Anesthesiology. 1989 Abstract
  19. Schmitt JP, Schwoerer D, Diemunsch P, Gauthier-Lafaye J. [Passage of propofol in the colostrum. Preliminary data]. Ann Fr Anesth Reanim. 1987 Abstract

Total visits

86,048

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 Asociación Pro Lactancia Materna (APROLAM) of Mexico

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