Document Detail

Oxycodone as a component of multimodal analgesia for lactating mothers after Caesarean section: relationships between maternal plasma, breast milk and neonatal plasma levels.
MedLine Citation:
PMID:  17550483     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Oxycodone has become popular for post-Caesarean section (CS) analgesia yet it is not currently recommended for use in breast-feeding mothers because of limited information on its excretion into breast milk. AIM: To investigate the relationship between maternal ingestion of oxycodone after CS and the resultant maternal plasma, breast milk and neonatal plasma drug levels up to 72-h post-partum. METHODS: Fifty breast-feeding mothers taking oxycodone had blood and breast milk samples analysed for oxycodone levels at 24 h intervals after CS. Forty-one neonates had blood samples taken at 48 h. RESULTS: Oxycodone was detected in the milk of mothers who had taken any dose in a 24-h period, with significant correlation between maternal plasma and milk levels (R(2) = 0.81). The median milk:plasma (M:P) ratio for the same period was 3.2:1. Over the subsequent 48 h, the relationship between plasma and milk levels was less strong (R(2) = 0.59) and there was a larger range of M:P levels with evidence of persistence of oxycodone in the breast milk of some mothers. Oxycodone levels up to 168 ng/mL were detected in breast milk (20% > 100 ng/mL). Oxycodone was detected in the plasma of one infant. CONCLUSIONS: Oxycodone is concentrated in human breast milk up to 72-h post-partum. Breastfed infants may receive > 10% of a therapeutic infant dose. However, maternal oxycodone intake up to 72-h post-CS poses only minimal risk to the breast-feeding infant as low volumes of breast milk are ingested during this period.
Suzette Seaton; Mark Reeves; Stuart McLean
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  47     ISSN:  0004-8666     ISO Abbreviation:  Aust N Z J Obstet Gynaecol     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-06     Completed Date:  2007-09-19     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  181-5     Citation Subset:  IM    
Rural Clinical School, North West Regional Hospital, Tasmania, Australia.
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MeSH Terms
Analgesics, Opioid / blood,  pharmacokinetics*
Cesarean Section / adverse effects*
Drug Administration Schedule
Infant, Newborn
Milk, Human / chemistry*,  drug effects
Oxycodone / blood,  pharmacokinetics*
Pain / drug therapy*
Reg. No./Substance:
0/Analgesics, Opioid; 76-42-6/Oxycodone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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