Norco 10/325

[Motherof2]

I have been prescribed Norco 10/325 for my severe back pain I've been having. This is only for short term use until I get better. I currently only take one pill typically around 8pm to help me when the pain is at its worst. I then pump and dump till around 5am the next morning and supplement with formula. I really don't want to take any chances of harming my 1 month old, with this medicine. Do you think I am pumping and dumping long enough that she doesn't get any of the medicine? I have been taking it for 5 days now, will it build up in my system?

Lastly I also was given Percocet 5/325, if the norco doesn't work and Flexeril 5mg. I've tried the flexeril but didn't think it help so I haven't taken it since. How are the effects of these drugs any one better/safer than another?

[cpride]

Dear Motherof2,

Norco is a combination of hydrocodone (narcotic analgesic) and acetaminophen (Tylenol). Percocet is a combination of oxycodone (also a narcotic analgesic) and acetaminophen. You should not exceed 40 mg of hydrocodone or oxycodone (combined total dose) in 24 hours to reduce the risk of sedation in your infant. You should not exceed 3000 mg of acetaminophen in 24 hours to prevent liver toxicity. The time hydrocodone is highest in your breastmilk (Tmax) is the first hour after your dose, and the half-life (time it takes for half of the medication to be eliminated from your system) is 4 hours after your dose. If you are waiting eight hours, that allows 75 percent of the drug to be eliminated. For oxycodone, the Tmax is one to two hours and the half-life is three to six hours. The main risk for your infant with both of these medications is sedation. Also, long term use of these medications may lead to dependence. We do not have data on how much cyclobenzaprine (Flexeril) enters breastmilk but the half-life is long at 24 to 72 hours so you may want to talk with your physician about an alternative called metaxalone (Skelaxin) as the half-life is much shorter at two to three hours if needed. You should also observe your infant for sedation with these medications. If you have further questions, please call the InfantRisk Center at 806-352-2519. We are open Monday through Friday, 8 to 5, CDT.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center