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Oxycodone while pregnant

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  • admin
    replied
    User70,

    Oxycodone is rated an P2 in pregnancy, benefits likely to exceed the risk. Neonates whose mothers have taken oxycodone chronically may exhibit respiratory depression and/or withdrawal symptoms, either at birth and/or in the nursery. Oxycodone hydrochloride tablets are not recommended for use in women during or immediately prior to labor. Occasionally, opioid analgesics may prolong labor through actions which temporarily reduce the strength, duration and frequency of uterine contractions. No increased malformation risk in small numbers. Reproduction studies in Sprague-Dawley rats and New Zealand rabbits revealed that when oxycodone was administered orally at doses up to 16 mg/kg (approximately 2 times the daily oral dose of 90 mg for adults on a mg/m2 basis) and 25 mg/kg (approximately 5 times the daily oral dose of 90 mg on a mg/m2 basis), respectively, it was not teratogenic or embryo-fetal toxic. There are no adequate and well controlled studies of oxycodone in pregnant women. Because animal reproductive studies are not always predictive of human responses, oxycodone hydrochloride tablets should be used during pregnancy only if potential benefit justifies the potential risk to the fetus. Neonates, whose mothers received opioid analgesics during labor, should be observed closely for signs of respiratory depression. A specific narcotic antagonist, naloxone, should be available for reversal of narcotic-induced respiratory depression in the neonate. (Medications and Mothers' Milk)

    Hydrocodone is rated an P3, unknown, risk to the fetus cannot be ruled out. There are no adequate and well-controlled studies in pregnant women.There does not appear to be an increased risk of major congenital anomalies if used in the first trimester but the numbers are small. (Briggs & Koren) Babies born to mothers who have been taking opioids regularly prior to delivery will be physically dependent. The withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning, vomiting, and fever. The intensity of the syndrome does not always correlate with the duration of maternal opioid use or dose. There is no consensus on the best method of managing withdrawal. Hydrocodone tablets should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. (Medications and Mothers' Milk)

    Mom should discuss this with her OB.

    Sandra Lovato R.N.
    InfantRisk Center
    806-352-2519
    Last edited by admin; 11-29-2016, 09:51 AM.

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  • User70
    replied
    Hello ,

    my gf is 7 weeks pregnant . she likes taking oxys or hydrocodone for pain she has, but I think she just likes the feeling they give her . I made her stop and now she's a miserable bitch and it's driving me crazy. can she take oxys or hydrocodone without making my baby a drooling idiot for the rest of its life? I'm worried but she insists it's safe. what should I do. Thank you .

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  • admin
    replied
    NikNak:

    Your fetus is getting about the same amount you are. The plasma levels in the infant are roughly equal to those of the mothers. See below


    Tom Hale Ph.d


    --------------------------------------------------------

    .
    Basic Clin Pharmacol Toxicol. ([url]http://www.ncbi.nlm.nih.gov/pubmed/22448718#[/url]) 2012 Sep;111(3):182-8. doi: 10.1111/j.1742-7843.2012.00884.x. Epub 2012 Apr 21.
    Intravenous oxycodone for pain relief in the first stage of labour--maternal pharmacokinetics and neonatal exposure.

    Author information ([url]http://www.ncbi.nlm.nih.gov/pubmed/22448718#[/url])

    Abstract

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  • NikNak
    replied
    if im taking 90mg of oxycodone a day at 34 weeks pregnant how much is my baby actually getting

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  • Shamita
    replied
    It is a class B drug. The oxycodone doesn't have the acetaminophen in it that alot of other pain meds do. Your doctors know what they are doing.

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  • jaftar
    replied
    Hi, Thank you so much for advice.

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  • admin-james
    replied
    Hi, thanks for your post.

    Yes, I think you should seek a second opinion. It is good that you are getting off of Percocet, and you should continue to wean slowly with plans to transition to something else, but I think the risks to the baby are being overestimated here. The American College of Obstetricians and Gynecologists is the professional think tank that issues best-practice guidelines for OB/GYNs. According to ACOG's committee opinion #524 (excerpted and cited at the bottom of this post), there is no solid evidence that in utero exposure to prescribed opiates causes significant long-term issues in children. There IS evidence that inadequately treated pain, depression, or anxiety may harm the baby by making the mother less capable/willing to take good care of herself (See ACOG practice bulletin #92).

    There are options for the treatment of anxiety and pain during pregnancy that are acceptable from a risk-to-benefit standpoint. ACOG recommends an individualized, multi-disciplinary approach where all available therapies can be discussed. In practice, this means consulting several experts, including specialists in pain and mental disorders, so that all of the choices can be on the table.

    -James Abbey, MD

    From ACOG Committee Opinion #524:
    "Previous reports have not shown an increase in risks of birth defects after prenatal exposure to oxycodone, propoxyphene, or meperidine. The authors of one retrospective study observed an increased risk of some birth defects with the use of prescribed opioids by women in the month before or during the first trimester of pregnancy. However, methodological problems with this study exist, and such an association has not been previously reported. The observed birth defects remain rare with a minute increase in absolute risk… Medically supervised withdrawal from opioids [of abuse] in opioid-dependent women is not recommended during pregnancy because the withdrawal is associated with high relapse rates… Recent data on long-term outcomes of infants with in utero opioid exposure are limited. For the most part, earlier studies have not found significant differences in cognitive development between children up to 5 years of age exposed to methadone in utero and control groups matched for age, race, and socioeconomic status, although scores were often lower in both groups compared with population data. Preventive interventions that focus on enriching the early experiences of such children and improving the quality of the home environment are likely to be beneficial."

    ACOG Committee on Health Care for Underserved Women; American Society of Addiction Medicine. ACOG Committee Opinion No. 524: Opioid abuse, dependence, and addiction in pregnancy. Obstet Gynecol. 2012 May;119(5):1070-6.

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  • Firsttimemommy
    replied
    4weeks

    Hi there...
    I am approx 4 weeks or a little less and was being weaned off Percocet. I have crones disease and have had a bowel resection. I was on 3 alternating with 4 percocets for 2 weeks, and then went to 3 for 2 weeks. It happened that I found out I was pregnant just before my appointment with my family doctor on Tuesday to check up on my weaning. She gave me 6 days to get off them. 2 for 3 days then 1 for 3 days then done. Reading what others have posted here, this seems harsh and unnecessary. I'm feeling very unwell. This is my first day at 1. Am I doing more harm than good coming off them this fast? I was also on anxiety melds which I can't take either. I feel horrible and want to know if I should seek a second opinion. Thank you.

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  • admin
    replied
    Dear Anamarie,

    Neonates whose mothers have taken oxycodone chronically may exhibit respiratory depression and/or withdrawal symptoms, either at birth and/or in the nursery. The 5-10mg dose you have been using is a small one, hopefully your baby will not withdraw, but we cannot say for sure. However, breastfeeding your baby is a good idea, it actually helps the baby not to withdraw. Please keep in mind that the amount of Oxycodone the baby gets in utero is way more than the amount he will get through breastmilk (1.5-3.5%). Furthermore, we do not encourage using it chronically after the baby is born.

    Oxycodone hydrochloride tablets are not recommended for use in women during or immediately prior to labor. Occasionally, opioid analgesics may prolong labor through actions which temporarily reduce the strength, duration and frequency of uterine contractions.

    Hope this helps!! If you have further questions please call me at the InfantRisk Center on 806-352-2519.

    Tassneem Abdel Karim, MD
    InfantRisk Center

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  • anamarie
    replied
    Hello I was referred by my LC that I have known for awhile now. This is my 3rd child and by far the most complex pregnancy. I am currently 34wks weeks pregnant and due to some conditions and issues that have arose I have been prescribed oxycodone 5mg w out tylenol for the past few months now. I do not nor have not taken it everyday and have never taken more then 2 in a day. I have already met with the NICU anesthesia and have spoken w my LC I have also done extensive research. That being said I still have worries and unclear information.I am aware that w any narcotic usage there is a chance of dependency and with drawls knowing that I have used my medicine as sparingly as possible sometimesa wWK and a half w nothing but Tylenol. I breastfed both my prior children for a yr and I am determined to be able to do so w this one. With all of the talk of withdrawals dependancy and newborn hospitilization I am worried about my child. In a worst case scenerio and my son had to stay in the NICU there would be no where for him and I to stay together to continuously breastfeed but I can visit. Is there a way to judge just by the minimal amounts I have taken that he will be admitted for withdrawals? Is there a safe period of time before my son is born to completely not take it and he will be OK?How long after I take it does he remain effected by it? Also in my research I have read that he can still be effected by it even after he us born because it passes through my breast milk and are traces of it for up to 72hrs and babies have ended up in the hospital. Would it be best if I don't take it at all while breastfeeding

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  • admin
    replied
    Ftmwithfibro:

    It is true that your infant will become dependent on oxycodone, and after birth will have to be managed for withdrawal. While withdrawal is not ideal, it does not necessarily mean lift-long problems for the infant. Most infants can be withdrawn over a week or more and do just fine thereafter.

    I'd suggest you maintain your pain control, and let your doctors worry about the withdrawal in your infant after delivery. If you want to breastfeed, you can do that as well, as the levels in milk will be far far lower than the amount the infant is getting during pregnancy. You again will have to withdraw the infant off the breast slowly to prevent mild withdrawal symptoms.

    Talk with your pediatrician about your upcoming delivery and the infant's withdrawal.

    Tom Hale Ph.D.

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