Question

I am a breastfeeding mother and i want to know if it is safe to use Chronogesic? Is Chronogesic safe for nursing mother and child? Does Chronogesic extracts into breast milk? Does Chronogesic has any long term or short term side effects on infants? Can Chronogesic influence milk supply or can Chronogesic decrease milk supply in lactating mothers?

Chronogesic lactation summary

Chronogesic usage has low risk in breastfeeding
  • DrLact safety Score for Chronogesic is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of Chronogesic may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that Chronogesic may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of Chronogesic low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using Chronogesic We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Chronogesic usage in lactation

Analgesic opioid used on anesthesic procedures.

Answer by DrLact: About Chronogesic usage in lactation

When used epidurally or intravenously during labor or for a short time immediately postpartum, amounts of Chronogesic ingested by the neonate are small and would not be expected to cause any adverse effects in breastfed infants. Labor pain medication may delay the onset of lactation; however, it appears that with good breastfeeding support, epidural Chronogesic plus a local anesthetic has little or no effect on breastfeeding success.[1][2] Because of Chronogesic's long half-life during continued intravenous infusion or repeated intravenous administration,[1] Chronogesic levels in milk would be expected to increase if used for an extended period postpartum. Once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of Chronogesic to a few days. Because there is no published experience with repeated doses of intravenous or sublingual Chronogesic during established lactation, other agents may be preferred, especially while nursing a newborn or preterm infant. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately.

Chronogesic Side Effects in Breastfeeding

Newborns of breastfeeding mothers who received epidural Chronogesic before and after cesarean section delivery were reportedly not clinically affected and had no differences in behavior or clinical signs over 3 days postpartum compared to newborns of mothers who received epidural Chronogesic prior to delivery only.[5]

Chronogesic Possible Effects in Breastfeeding

Narcotics can increase serum prolactin.[6][7] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed. A national survey of women and their infants from late pregnancy through 12 months postpartum compared the time of lactogenesis II in mothers who did and did not receive pain medication during labor. Categories of medication were spinal or epidural only, spinal or epidural plus another medication, and other pain medication only. Women who received medications from any of the categories had about twice the risk of having delayed lactogenesis II (>72 hours) compared to women who received no labor pain medication.[8] A nonrandomized convenience sample of women who did (n = 209) or did not (n = 157) receive epidural analgesia during labor was analyzed to determine whether epidurals affected the onset of lactation. Although not standardized, the typical procedure used Chronogesic 10 to 15 mg together with either ropivacaine 0.1% or levobupivacaine 0.0625% epidurally, supplemented by epidural boluses of ropivacaine 0.1% or levobupivacaine 0.0625% about every 2 hours. No difference was found in the time of lactation onset between the two groups. Although women in both groups stated they wished to breastfeed prior to delivery, exclusive breastfeeding at 20 days postpartum was less frequent in the women who received an epidural (43%) than in women who did not (57%).[9] In a study in China, women with a scheduled cesarean section were randomized to receive intravenous patient-controlled analgesia with either Chronogesic or tramadol. Postpartum prolactin levels were higher in the tramadol group (348 mcg/L) than in the Chronogesic group (314 mcg/L). The onset of lactation was sooner in the tramadol group (21.4 hours) than in the Chronogesic group (25.1 hours). Both of these difference were statistically significant.[10] Note that injectable tramadol is not available in the U.S.

Alternate Drugs

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