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Changing from Oxycodone to Morphine while breastfeeding

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  • Changing from Oxycodone to Morphine while breastfeeding

    I deal with severe pain daily due to MS. I've been using Oxycodone since before my pregnancy, then during (25mg/day) and now 5 months later while breastfeeding (40mg/day). My pain management doctor gave me the option to switch to morphine, due to my tolerance to Oxycodone. Is morphine better for my 5 month old? Would there be an issue if I need to increase my dose? I don't want to increase my Oxycodone dose again, since I'm already taking a lot (for him). I don't want the change to have any adverse reactions for him. He has been exposed his whole life and wouldn't want him to go through withdrawl if I switch. Any information is greatly appreciated.

  • #2
    Pumpkin,

    Morphine is rated an L3-limited data-probably compatible. The amount transferred into the breast milk is 9.09-35% of your dose, but only 26% of that amount is orally bioavailable to the infant. For the immediate release tablet try to avoid the first 2 hours after taking a dose to breastfeed and at that point half the medication is out. Try to keep your dose low and monitor your infant for s[COLOR=#333333][FONT=lucida grande]edation, slowed breathing rate/apnea, pallor, constipation and appropriate weight gain.

    If you decide to stay on the Oxycodone and increase your dose that is probably ok also. We normally do not recommend taking more than 40mg in 24 hours, but like you your infant will become tolerant of this medication since they were exposed in utero and throughout breastfeeding, so as long as your infant is tolerating the higher dose and is not symptomatic it is probably ok. Increase your dose slowly, avoid the first 2 hours after a dose to breastfeed, monitor your infant for sedation, slowed breathing rate/apnea, pallor, constipation and appropriate weight gain.

    Please be aware with either of these medications that you will need to wean your infant off the breast slowly when you decide to stop breastfeeding so your infant will not go through withdrawal.[/FONT][/COLOR]

    I hope this helps.

    Sandra Lovato R.N.
    InfantRisk Center
    806-352-2519

    Comment


    • #3
      My doctor also mentioned time release morphine, as well as Oxycodone. Does that effect waiting 2 hours to breastfeed after taking it? Should I stick to immediate release if I switch or even stay on oxycodone? I'd only switch to morphine to try to keep my dose lower.
      Thank you

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      • #4
        Pumpkin,

        The extended release capsules are intended to keep your levels higher for prolonged periods of time to help with pain control, so trying to avoid certain times is not necessary, just monitor your infant for possible side effects such as s[COLOR=#333333][FONT=lucida grande]edation, slowed breathing rate/apnea, pallor, constipation and appropriate weight gain.

        Sandra Lovato R.N.
        InfantRisk Center
        806-325-2519[/FONT][/COLOR]

        Comment

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