Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Drugline nr 22271

Publicerat 2005-08-25

Question

Is the use of oxycodone (Oxycontin) compatible with breast-feeding?

This is a general question.

Answer

Oxycodone is a semisynthetic opioid analgesic with an oral bioavailability of 60-87% (1). Oxycodone is metabolised into three metabolites. Oxymorphone is an active metabolite, and the formation of it appears to be mediated by CYP2D6. The AUC of oxymorphone is 1-12% of the oxycodone AUC (2).

Short-term use of most opioids is considered compatible with breast-feeding. One exception is pethidine, since the metabolite is accumulated in breast milk and there are reports of CNS effects in infants exposed trough breast milk (3).

One study investigating the excretion of oxycodone into breast milk has been found. The study is published as an abstract and therefore some study data are lacking. Oxycodone in combination with paracetamol was given to six nursing women as pain treatment after caesarean section. Unfortunately the dose oxycodone used is not specified and might have varied between 17 mg/d and 60 mg/d. The mothers plasma concentrations were 14-35 ng/ml and the concentration in milk varied from <5 up to 226 ng/ml. The concentration in milk peaked 1.5-2 hours after oxycodone intake. Since the mothers doses are not known, the infant would in the "worst" case scenario recieve 12% of the mothers weight adjusted dose. According to the authors, who probably knew the doses, the infant dose would not exceed 8% of the mothers weight adjusted dose. No data on eventual side effects observed among the infants are presented (4).

No other reports of the use of oxycodone during breast feeding have been found.

Short-term use of oxycodone appears to be compatible with breast-feeding, but it is recommended that the infant is monitored for opioid related adverse effects, especially if the infant is born premature.

Conclusion

Availiable data on oxycodone and breast-feeding is sparse. Short-term use of oxycodone appears to be compatible with breast-feeding.

Andersson M
Hellden A

References

  1. Oxycodone. Drugdex(R) System; Thomson MICROMEDEX, Greenwood Village, Colorado (2005-08-25).
  2. Levy RH, Thummel KE, Trager WF, Hansten PD, Eichelbaum M. Metabolic drug interactions. Philadelphia: Williams & Wilkins; 2000.
  3. Läkemedel och amning. Available from: URL: http://www.janusinfo.se (2005-08-25).
  4. Marx CM, Pucino F, Carlson JD, Driscoll JW, Ruddock V. Oxycodone excretion in human milk in the puerperium. Drug Intell Clin Pharm 1986;20:474.

Senast ändrad 2018-09-20