Last update Feb. 5, 2022

Sufentanil Citrate

Low Risk

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

Opioid analgesic similar to fentanyl but with much more powerful action. Indicated for the control of labor and postoperative pain, in combination with general or epidural anesthesia. Intravenous or epidural administration.

It is excreted in colostrum and breast milk in small amounts (Cuypers 1995) or is not detectable (Madej 1987) and no problems have been observed in infants of mothers treated with epidural sufentanil. (Cuypers 1995)

Intravenous administration of sufentanil in planned caesarean sections may delay the onset of breastfeeding. (Chi 2017)

Epidural administration of sufentanil during labor does not cause a delay in the initiation of breastfeeding (Xu 2020, Mauri 2015), especially if there is no separation of mother and baby (joint accommodation 24 hours a day) during the hospital stay. (Zuppa 2014)

Epidural administration of sufentanil during labor may (Mauri 2015) or may not (Xu 2020) be associated with a shorter duration of exclusive breastfeeding.

The impact of epidural anesthesia on infancy is controversial. (Howie 2006)

Expert authors consider the epidural administration of sufentanil to be probably compatible (Reece 2017, Briggs 2015, Nice 2004, Spigset 1994, Lee 1993) and, even together with fentanyl, the opioid analgesic of choice during breastfeeding. (Schaefer 2015)

Until more published data are known about this drug in relation to breastfeeding, known safer alternatives may be preferable, especially during the neonatal period and in the event of prematurity.

Alternatives

  • Dexibuprofen ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Fentanyl ( 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

Sufentanil Citrate in other languages or writings:

Group

Sufentanil Citrate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Sufentanil Citrate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. baja - poor %
Molecular weight 579 daltons
Protein Binding 91 %
VD 0.2 - 4.9 l/Kg
Tmax 0.2 hours
2.7 hours

References

  1. Xu Q, Wu ZF, Yang NN, Shi M, Zhu ZQ. Impact of epidural analgesia during labor on breastfeeding initiation and continuation: a retrospective study. J Matern Fetal Neonatal Med. 2020 Nov;33(22):3816-3819. Abstract
  2. AEMPS. Sufentanilo. Ficha técnica. 2018 Full text (in our servers)
  3. Chi X, Li M, Mei W, Liao M. Comparison of patient-controlled intravenous analgesia with sufentanil versus tramadol in post-cesarean section pain management and lactation after general anesthesia - a prospective, randomized, double-blind, controlled study. J Pain Res. 2017 Jul 3;10:1521-1527. Abstract Full text (link to original source) Full text (in our servers)
  4. 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)
  5. Mauri PA, Contini NN, Giliberti S, Barretta F, Consonni D, Negri M, Di Benedetto I. Intrapartum epidural analgesia and onset of lactation: a prospective study in an Italian birth centre. Matern Child Health J. 2015 Mar;19(3):511-8. Abstract
  6. Zuppa A, Alighieri G, Riccardi R, Cavani M, Iafisco A, Cota F, Romagnoli C. Epidural analgesia, neonatal care and breastfeeding. Ital J Pediatr. 2014 Abstract Full text (link to original source) Full text (in our servers)
  7. Sandoz. Sufentanil. Drug Monograph. 2014 Full text (in our servers)
  8. 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)
  9. Nice FJ, De Eugenio D, Dimino TA, Freeny IC, Rovnack MB, Gromelski JS. Medications and Breast-Feeding: A Guide for Pharmacists, Pharmacy Technicians, and Other Healthcare Professionals. Part I. J Pharm Technol 2004;20:17-27. doi: 10.1177/875512250402000106.
  10. Cuypers L, Wielalck A, Vertommen JD, Van Aken H. Epidural sulfentanil for postcaesarean pain: breast milk levels and effects on the baby. Acta Anaesthesiol Belgica 1995;46:104-5.
  11. Spigset O. Anaesthetic agents and excretion in breast milk. Acta Anaesthesiol Scand. 1994 Abstract
  12. 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)
  13. Madej TH, Strunin L. Comparison of epidural fentanyl with sufentanil. Analgesia and side effects after a single bolus dose during elective caesarean section. Anaesthesia. 1987 Abstract

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