Fentanyl Patch, Extended Release Breastfeeding
Do you know that important immune protective proteins are present in breast milk? Breast milk also contains required vitamins, minerals, saturated and un saturated fats. These things are extremely important for development of healthy brain. If you are taking any medicine for short term or for the chronic reason then that passes in breast milk as well, that is why you should always check the drug with your health care provider. Here at DrLact we try to analyze drugs based on available researches and in this sheet we will present our analysis for Fentanyl Patch, Extended Release.

What is Fentanyl Patch, Extended Release used for?


Fentanyl transdermal system is indicated for management of persistent, moderate to severe chronic pain that: requires continuous, around-the-clock opioid administration for an extended period of time, and cannot be managed by other means such as non-steroidal analgesics, opioid combination products, or immediate-release opioids. Fentanyl transdermal system should ONLY be used in patients who are already receiving opioid therapy, who have demonstrated opioid tolerance, and who require a total daily dose at least equivalent to fentanyl transdermal system 25 mcg/h (see DOSAGE AND ADMINISTRATION ). Patients who are considered opioid-tolerant are those who have been taking, for a week or longer, at least 60 mg of morphine daily, or at least 30 mg of oral oxycodone daily, or at least 8 mg of oral hydromorphone daily, or an equianalgesic dose of another opioid. Because serious or life-threatening hypoventilation could result, fentanyl transdermal system is contraindicated for use on an as needed basis (i.e., prn), for the management of post-operative or acute pain, or in patients who are not opioid-tolerant or who require opioid analgesia for a short period of time. (see BOX WARNING and CONTRAINDICATIONS ). An evaluation of the appropriateness and adequacy of treating with immediate-release opioids is advisable prior to initiating therapy with any modified-release opioid. Prescribers should individualize treatment in every case, initiating therapy at the appropriate point along a progression from non-opioid analgesics, such as non-steroidal anti-inflammatory drugs and acetaminophen, to opioids, in a plan of pain management such as outlined by the World Health Organization, the Agency for Health Research and Quality, the Federation of State Medical Boards Model Policy, or the American Pain Society. Patients should be assessed for their clinical risks for opioid abuse or addiction prior to being prescribed opioids. Patients receiving opioids should be routinely monitored for signs of misuse, abuse, and addiction. Persons at increased risk for opioid abuse include those with a personal or family history of substance abuse (including drug or alcohol abuse or addiction) or mental illness (e.g., major depression). Patients at increased risk may still be appropriately treated with modified-release opioid formulations; however these patients will require intensive monitoring for signs of misuse, abuse, or addiction.

Fentanyl Patch, Extended Release while breastfeeding safe or not? Can there be any side effects for infant while using it during breastfeeding?

Fentanyl Patch, Extended Release safe for breastfeeding
Fentanyl is the only one ingredient used in manufacturing of Fentanyl Patch, Extended Release, Which makes it easier to analyze its effect in breastfeeding. As per our analysis of Fentanyl it is safe to use Fentanyl Patch, Extended Release while lactating. We suggest you to check further details below about Fentanyl usage in breastfeeding.

Statement of Manufacturer/Labeler about breastfeeding usage
Nursing Mothers Fentanyl is excreted in human milk; therefore, fentanyl transdermal system is not recommended for use in nursing women because of the possibility of effects in their infants.

Fentanyl Patch, Extended Release Breastfeeding Analsys


Fentanyl while Breastfeeding

Safe

CAS Number: 437-38-7

Opium-derived analgesic that is used through several ways of administration (epidural, intravenous, mouth, skin). It is excreted into breast milk in non-significant amount without observed problems among infants from treated mothers. Plasma levels of those infants were undetectable. It has been authorized for treatment of small infants and neonates. After a mother has underwent anesthesia by the use of Fentanyl, she may breastfeed her baby as soon as her recovery and general conditions may permit it. Fentanyl stimulates secretion of Prolactin, however, after Lactation has been established, Prolactin level has a poor relationship with production of mother's milk. There is controversy about the effect of analgesic medication used for labor management (Epidural anesthesia with Fentanyl added or not ) on the initiation of breastfeeding, both on starting of phase II of Lactogenesis or the infant ability for suckling. Some studies have pointed out to a higher risk for a delay in the initiation of Lactogenesis II (milk coming in) for longer than 3 days after birth, even though it would not affect the weight loss of the newborn. Other studies have found a higher risk for a delay in the first latch-on at the breast, higher body temperature and irritability or somnolence. Some others however, failed to show the same findings. It appears to be of more paramount importance the women's support for the establishment and continuation of breastfeeding, than the negative effect that would be exerted by administration of analgesia or anesthesia during labor. Fentany has lesser effect than Pethidine (Demerol) on initiation of breastfeeding. It occurs a higher milk production and weight increase of the infant if there is an adequate pharmacological control of the pain that appears after vaginal birth or C-section. The American Academy of Pediatrics - says that is usually compatible with breastfeeding.


Fentanyl Patch, Extended Release Breastfeeding Analsys - 2


Fentanyl while Breastfeeding

CAS Number: 437-38-7

When used epidurally or intravenously during labor or for a short time immediately postpartum, amounts of fentanyl ingested by the neonate are usually small and are not expected to cause any adverse effects in breastfed infants. The results of studies on the effect of epidural fentanyl on breastfeeding initiation and duration are mixed and controversial, because of the many different combinations of drugs, dosages and patient populations studied as well as the variety of techniques used and deficient designs of many of the studies. In infants placed skin-to-skin after a normal vaginal delivery, epidural fentanyl given during labor may delay the infant's first suckling in a dose-dependent manner,[1] perhaps because it can persist in the infant's serum for over 24 hours after discontinuation.[2] However, it appears that with good breastfeeding support, epidural fentanyl plus bupivacaine has little overall effect on breastfeeding success.[3][4][5][6][7] No waiting period or discarding of milk is required before resuming breastfeeding after fentanyl is used for short procedures (e.g., for endoscopy).[8][9] After general anesthesia, breastfeeding can be resumed as soon as the mother has recovered sufficiently from anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure. Limited information indicates that transdermal fentanyl in a dosage of 100 mcg/hour results in undetectable fentanyl concentrations in breastmilk. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. Once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of fentanyl to a few days at a low dosage with close infant monitoring. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately.



I already used Fentanyl Patch, Extended Release and meanwhile I breastfed my baby should I be concerned?

It is always a good idea to keep your healthcare provider or doctor informed about your drug usage during pregnancy and breastfeeding but if you have not informed your doctor about Fentanyl Patch, Extended Release and have used it then do not panic as Fentanyl Patch, Extended Release is mostly safe in breastfeeding and should not cause any harm to your baby.


I am nursing mother and my doctor has suggested me to use Fentanyl Patch, Extended Release, is it safe?

Usage of Fentanyl Patch, Extended Release is safe for nursing mothers and baby, No worries.


If I am using Fentanyl Patch, Extended Release, will my baby need extra monitoring?

No


Who can I talk to if I have questions about usage of Fentanyl Patch, Extended Release in breastfeeding?

US
National Womens Health and Breastfeeding Helpline: 800-994-9662 (TDD 888-220-5446) 9 a.m. and 6 p.m. ET, Monday through Friday

UK
National Breastfeeding Helpline: 0300-100-0212 9.30am to 9.30pm, daily
Association of Breastfeeding Mothers: 0300-330-5453
La Leche League: 0345-120-2918
The Breastfeeding Network supporter line in Bengali and Sylheti: 0300-456-2421
National Childbirth Trust (NCT): 0300-330-0700

Australia
National Breastfeeding Helpline: 1800-686-268 24 hours a day, 7 days a week

Canada
Telehealth Ontario for breastfeeding: 1-866-797-0000 24 hours a day, 7 days a week