Last update: June 10, 2014

Oxycodone

High Risk for breastfeeding


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

Very often used for treatment of pain associated to episiotomy or Cesarean section operation.

Excreted and accumulates into breast milk in significant amount along with associated problems among 20% of breastfed infants from treated mothers. Side effects have been rarely severe like excessive sedation, letargia, hypothermia and apnea. Dose should not be higher than 30 mg a day for no longer than 3 days.

Women with some variants of enzyme-linked gene CYP2D6 who are on Oxycodone and their breastfed infants may experience increased sedation. Dose should not be higher than 30 mg a day for no longer than 3 days.

Use of Oxycodone during childhood is risky because of a large elimination half-life variability.

Adequately use of nonsteroidal anti-inflammatory drugs (NSAIDs) may attain pain relief with less side effects than with narcotic analgesics.

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Group

Oxycodone belongs to this group or family:

Tradenames

Main tradenames from several countries containing Oxycodone in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 60 - 87 %
Molecular weight 315 daltons
Protein Binding 45 %
VD 2,6 l/Kg
Tmax 1 - 2 hours
T1/2 3,5 - 6 hours
M/P ratio 3,4 -
Theoretical Dose 0,0087 - 0,0025 mg/Kg/d
Relative Dose 2,6 - 7,6 %

References

  1. 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)
  2. Timm NL. Maternal use of oxycodone resulting in opioid intoxication in her breastfed neonate. J Pediatr. 2013 Abstract
  3. Lam J, Kelly L, Matok I, Ross CJ, Carleton BC, Hayden MR, Madadi P, Koren G. Putative association of ABCB1 2677G>T/A with oxycodone-induced central nervous system depression in breastfeeding mothers. Ther Drug Monit. 2013 Abstract
  4. Lam J, Kelly L, Ciszkowski C, Landsmeer ML, Nauta M, Carleton BC, Hayden MR, Madadi P, Koren G. Central nervous system depression of neonates breastfed by mothers receiving oxycodone for postpartum analgesia. J Pediatr. 2012 Abstract Full text (link to original source) Full text (in our servers)
  5. van den Anker JN. Is it safe to use opioids for obstetric pain while breastfeeding? J Pediatr. 2012 Abstract Full text (in our servers)
  6. Rivers CM, Olsen D, Nelson LS. Breastfeeding and oxycodone. J Pediatr. 2012 Abstract Full text (in our servers)
  7. Sulton-Villavasso C, Austin CA, Patra KP, Sankararaman S, Ray M, May R, Bordley C. Index of suspicion. Case 1: Infant who has respiratory distress. Case 2: Abnormal behavior, seizures, and altered sensorium in a 7-year-old boy. Case 3: Fever and dysphagia in a 4-year-old girl. Pediatr Rev. 2012 Abstract
  8. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract Full text (link to original source) Full text (in our servers)
  9. Seaton S, Reeves M, McLean S. Oxycodone as a component of multimodal analgesia for lactating mothers after Caesarean section: relationships between maternal plasma, breast milk and neonatal plasma levels. Aust N Z J Obstet Gynaecol. 2007 Abstract
  10. Pokela ML, Anttila E, Seppälä T, Olkkola KT. Marked variation in oxycodone pharmacokinetics in infants. Paediatr Anaesth. 2005 Abstract
  11. Levine B, Moore KA, Aronica-Pollak P, Fowler DF. Oxycodone intoxication in an infant: accidental or intentional exposure? J Forensic Sci. 2004 Abstract

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