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TRAMADOL, DEXKETOPrOFEN and PREGABALINA, help!

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  • TRAMADOL, DEXKETOPrOFEN and PREGABALINA, help!

    The neurologist send me TRAMADOL, PREGABALINA, and DEXKETOPrOFEN, he told me I can't breast feed on them, is that true?, I read they are low risk, but I want your opinion, I don't want to stop breastfeeding. Thank you (I'm breastfeeding a 27 months old toddler), he wants me to take the PREGABALIN for three months 75 mg twice a day, the DEXKETOPREN 25mg three times a day for 15 days, and TRAMADOL every 8 hours for 15 days too. Thanks
    Last edited by ButterCup; 07-29-2016, 06:04 AM.

  • #2
    Buttercup,

    Tramadol is rated an L3-limited data-probably compatible. The amount transferred into breastmilk is 2.86% of your dose. It is most concentrated in the milk in the first 2 hours after a dose. Try and take the medication after feeding so you have a break before feeding again. No significant neurobehavioral adverse effects were noted between controls and exposed infants. Based on these studies, it may be concluded that tramadol is compatible with breastfeeding. Monitor your toddler for sedation, slowed breathing rate/apnea, pallor, constipation and not waking to feed/poor feeding.

    Pregabalin is rated an L3-no data-probably compatible. While there are no data on its transfer into human milk, it should be expected. Due to the kinetics of the drug, its passage into the milk compartment is probable, and its oral bioavailability to the infant would be high. Therefore, nursing mothers should use caution in taking pregabalin while nursing. This drug is most concentrated in the first 1 1/2 hours after taking a dose so try and avoid feeding during that time. Monitor your toddler for sedation, slowed breathing rate/apnea, constipation and not waking to feed/poor feeding.

    Dexketoprofen is not in our data but it is very similar to ketoprofen which is an L2-limited data-probably compatible. The molecular weight is virtually the same and so is the protein binding of 99%. The amount of ketoprofen transferred into breast milk is only 0.3% of your dose. The dexketoprofen has a short half-life of 2 hours. This medication would also probably be ok to take if you waited a few hours to feed after taking a dose. Monitor your toddler for vomiting and diarrhea.

    Your child is older and not getting as much milk as a newborn and is better able to metabolize these medications so probably ok to breastfeed if your child is not symptomatic. Try to wait 3-4 hours after a dose to breastfeed.

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

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    • #3
      Thank you Mrs. Sandra, i was reeading that Gabapectin acta the same as pregabaline?, would that be a better option?, another thing is, that my toddler is very very insistent on nursing since I have a,ways nursed on demand, how terrible is if she can't wait three to four hours?, should i consider weaning with all this meds or you don't think it's necessary?, I really don't want to hurt her. Thank you very much.

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      • #4
        Buttercup,

        Gabapentin is probably a better alternative to pregabalin. Gabapentin is rated an L2-limited data- probably compatible. The amount transferred into milk is 6.6% of your dose. It is most concentrated in the milk in the first 3 hours after a dose. Monitor for sedation or irritability, not waking to feed/poor feeding, vomiting, tremor.

        I would recommend waiting at least 3 hours to feed.

        Sandra Lovato R.N.

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        • #5
          My Dr.mdidnt want to change me to gabaoextine, he said I would require a way bigger dose and that that was worse, don't know what to do.

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