Last update Aug. 5, 2022

C9H13NO3

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Adrenaline or epinephrine is a hormone and neurotransmitter used to treat allergic reactions, asthma, restore heart rhythm, control mucosal congestion, and glaucoma. Used as a systemic drug for cardiac resuscitation, asthma and anaphylaxis and locally in topical anesthetic preparations, epidural anesthesia, eye drops (mydriatic), and nasal drops (vasoconstrictor).

At last update no published data on excretion in breast milk were found.

Its rapid metabolism (short Tmax and T½, less than 5 minutes) makes it very unlikely an excretion into milk in significant amounts.

Furthermore, it is destroyed in the gastrointestinal tract. The low oral-bioavailability makes its levels into infant's plasma, that would be absorbed from ingested breast milk, be nil or negligible. (Nice 2000)

No problems have been observed in infants of mothers treated with adrenaline. (Shanks 2009)

Local infiltration of lidocaine and epinephrine into the caesarean section wound allowed an earlier initiation of lactation than with lidocaine alone. (Tharwat 2016)

Maintained high intravenous doses decrease milk production by interfering with the secretion of prolactin (Nicoletti 1984), especially the early postpartum-weeks, because when breastfeeding is well established, prolactin levels do not correlate with milk production any longer.

No problems related to lactation have been observed due to epidural anesthesia in which epinephrine is used. (Chang 2005, Radzyminski 2003)

Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs: compatible with breastfeeding. (WHO-UNICEF 2002)

TOPICAL USE:

The small dose and poor plasma absorption of most topical dermatological, nasal and ophthalmic  preparations make it unlikely that a significant amount will pass into breast milk. (Butler 2014)

In ophthalmological use, systemic absorption should be minimized by pressing the tear duct (inner corner of the eye) with the finger for 1 to 2 minutes and administering the dose immediately after breastfeeding. (Belkin 2020, Blumen 2020, Méndez 2012)

Alternatives

We do not have alternatives for C9H13NO3 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

C9H13NO3 is Adrenaline in Molecular formula.

Is written in other languages:

C9H13NO3 is also known as

Tradenames

Main tradenames from several countries containing C9H13NO3 in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 183 daltons
Tmax 0.1 hours
0.02 - 0.08 hours

References

  1. Belkin A, Chen T, DeOliveria AR, Johnson SM, Ramulu PY, Buys YM; American Glaucoma Society and the Canadian Glaucoma Society.. A Practical Guide to the Pregnant and Breastfeeding Patient with Glaucoma. Ophthalmol Glaucoma. 2020 Mar - Apr;3(2):79-89. Abstract
  2. Blumen-Ohana E, Sellem E. [Pregnancy & glaucoma: SFO-SFG recommendations]. J Fr Ophtalmol. 2020 Jan;43(1):63-66. Abstract
  3. Tharwat AA, Yehia AH, Wahba KA, Ali AE. Efficacy and safety of post-cesarean section incisional infiltration with lidocaine and epinephrine versus lidocaine alone in reducing postoperative pain: A randomized controlled double-blinded clinical trial. J Turk Ger Gynecol Assoc. 2016 Jan 12;17(1):1-5. Abstract Full text (link to original source) Full text (in our servers)
  4. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  5. Méndez-Hernández C. Uso de fármacos antiglaucomatosos durante el embarazo y lactancia. [Use of glaucoma medications during pregnancy and breastfeeding]. Arch Soc Esp Oftalmol. 2012 Dec;87(12):389-91. Abstract
  6. Shank JJ, Olney SC, Lin FL, McNamara MF. Recurrent postpartum anaphylaxis with breast-feeding. Obstet Gynecol. 2009 Aug;114(2 Pt 2):415-6. Abstract
  7. Chang ZM, Heaman MI. Epidural analgesia during labor and delivery: effects on the initiation and continuation of effective breastfeeding. J Hum Lact. 2005 Abstract
  8. Radzyminski S. The effect of ultra low dose epidural analgesia on newborn breastfeeding behaviors. J Obstet Gynecol Neonatal Nurs. 2003 Abstract
  9. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  10. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000 Nov;16(4):319-31. Review. Erratum in: J Hum Lact 2001 Feb;17(1):90. Abstract
  11. Nicoletti I, Filipponi P, Sfrappini M, Fedeli L, Petrelli S, Gregorini G, Santeusanio F, Brunetti P. Catecholamines and pituitary function. I. Effects of catecholamine synthesis inhibition and subsequent catecholamine infusion on gonadotropin and prolactin serum levels in normal cycling women and in women with hyperprolactinemic amenorrhea. Horm Res. 1984 Abstract

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