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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.