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Oxycodone as a component of multimodal analgesia for lactating mothers after Caesarean section: relationship between maternal plasma, breast milk and neonatal plasma levels

Citation

Seaton, S and Reeves, MD and McLean, SR, Oxycodone as a component of multimodal analgesia for lactating mothers after Caesarean section: relationship between maternal plasma, breast milk and neonatal plasma levels, Australian and New Zealand Journal of Obstetrics and Gynaecology, 47, (3) pp. 181-185. ISSN 0004-8666 (2007) [Refereed Article]


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The definitive published version is available online at: http://onlinelibrary.wiley.com/

Official URL: http://onlinelibrary.wiley.com/

DOI: doi:10.1111/j.1479-828X.2007.00715.x

Abstract

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. © 2007 The Authors Journal compilation © 2007 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Paediatrics and Reproductive Medicine
Research Field:Obstetrics and Gynaecology
Objective Division:Health
Objective Group:Specific Population Health (excl. Indigenous Health)
Objective Field:Child Health
Author:Seaton, S (Mrs Suzette Seaton)
Author:Reeves, MD (Dr Mark Reeves)
Author:McLean, SR (Professor Stuart McLean)
ID Code:48980
Year Published:2007
Web of Science® Times Cited:26
Deposited By:Pharmacy
Deposited On:2007-08-01
Last Modified:2011-04-27
Downloads:0

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