The Basics
What is Oxycodone?
Can treat moderate to severe pain.
Brand names for Oxycodone
Dazidox, Eth-Oxydose, Oxaydo, Oxycontin, Oxycontin Cr, Oxydose, Oxyfast, Oxy Ir, Roxicodone, Roxicodone Intensol
How Oxycodone is classified
Analgesics – Opioid, Narcotics, Antitussive Agents, Opiates
Oxycodone During Pregnancy
Oxycodone pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Oxycodone while pregnant
N/A
Taking Oxycodone While Breastfeeding
What are recommendations for lactation if you're taking Oxycodone?
Maternal use of oral narcotics during breastfeeding can cause infant drowsiness, central nervous system depression and even death. Infant sedation is common and well documented with maternal use of oxycodone. 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 oral oxycodone (and combinations) to a 2 to 3 days, especially in the outpatient setting.[1] A maximum oxycodone dosage of 30 mg daily is suggested, although some sources recommend avoiding oxycodone during breastfeeding.[2][3] Oxycodone elimination is decreased in young infants with much inter-individual variability. Monitor the infant closely for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. Other agents are preferred over oxycodone during breastfeeding.[2]
Maternal / infant drug levels
Maternal use of oral narcotics during breastfeeding can cause infant drowsiness, central nervous system depression and even death. Infant sedation is common and well documented with maternal use of oxycodone. 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 oral oxycodone (and combinations) to a 2 to 3 days, especially in the outpatient setting.[1] A maximum oxycodone dosage of 30 mg daily is suggested, although some sources recommend avoiding oxycodone during breastfeeding.[2][3] Oxycodone elimination is decreased in young infants with much inter-individual variability. Monitor the infant closely for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. Other agents are preferred over oxycodone during breastfeeding.[2]
Possible effects of Oxycodone on milk supply
Oxycodone can increase serum prolactin.[14] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Possible alternatives to Oxycodone
Acetaminophen, Butorphanol, Hydromorphone, Ibuprofen, Morphine.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Ito S. Opioids in breast milk: Pharmacokinetic principles and clinical implications. J Clin Pharmacol. 2018;58 (Suppl 10):S151-S163. PMID: 30248201
2. Sachs HC and the American Academy of Pediatrics committee on Drugs. The transfer of drugs and therapeutics into human breast milk: An update on selected topics. Pediatrics. 2013;132:e796-809. PMID: 23979084
3. Lamvu G, Feranec J, Blanton E. Perioperative pain management: An update for obstetrician-gynecologists. Am J Obstet Gynecol. 2018;218:193-9. PMID: 28666699
4. Baselt RC. Disposition of toxic drugs and chemicals in man. 6th ed. Foster City: Biomedical Publications, 2002:787-9.
5. Pokela ML, Anttila E, Seppala T et al. Marked variation in oxycodone pharmacokinetics in infants. Paediatr Anaesth. 2005;15:560-5. PMID: 15960639
6. Marx CM, Pucino F, Carlson JD et al. Oxycodone excretion in human milk in the puerperium. Drug Intell Clin Pharm. 1986;20:474. Abstract.
7. Seaton S, Reeves M, McLean S. Oxycodone as a component of multimodal analgesia for lactating mothers after Caesarean section: Relationships between maternal plasma, breast milk and neonatal plasma levels. Aust N Z J Obstet Gynaecol. 2007;47:181-5. PMID: 17550483
8. Sulton-Villavasso C, Austin CA, Patra KP et al. Index of suspicion. Case 1: Infant who has respiratory distress. Case 2: Abnormal behavior, seizures, and altered sensorium in a 7-year-old boy. Case 3: Fever and dysphagia in a 4-year-old girl. Pediatr Rev. 2012;33:279-84. PMID: 22659261
9. Levine B, Moore KA, Aronica-Pollak P et al. Oxycodone intoxication in an infant: accidental or intentional exposure? J Forensic Sci. 2004;49:1358-60. PMID: 15568714
10. Rampono J, Kristensen JH, Ilett KF, Hackett LP, Kohan R. Quetiapine and breast feeding. Ann Pharmacother. 2007;41:711-4. PMID: 17374621
11. Lam J, Kelly L, Ciszkowski C et al. Central nervous system depression of neonates breastfed by mothers receiving oxycodone for postpartum analgesia. J Pediatr. 2012;160:33-37.e2. PMID: 21880331
12. Timm NL. Maternal use of oxycodone resulting in opioid intoxication in her breastfed neonate. J Pediatr. 2013;162:421-2. PMID: 23063265
13. Beauchamp GA, Hendrickson RG, Horowitz BZ et al. Exposures through breast milk: An analysis of exposure and information calls to U.S. poison centers, 2001-2017. Breastfeed Med. 2019. PMID: 31211594
14. Saarialho-Kere U, Mattila MJ, Seppala T. Psychomotor, respiratory and neuroendocrinological effects of a mu-opioid receptor agonist (oxycodone) in healthy volunteers. Pharmacol Toxicol. 1989;65:252-7. PMID: 2555803
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
