title: Breast milk hydrocodone and hydromorphone levels in mothers using hydrocodone for postpartum pain.
abstract: OBJECTIVE
  To estimate the extent of passage of hydrocodone and its active metabolite, hydromorphone, into breast milk.
  
  
  METHODS
  This is a pharmacokinetic study of 30 postpartum women receiving hydrocodone bitartrate for postpartum pain in the inpatient setting. Mothers donated timed breast milk samples for the analysis of hydrocodone and hydromorphone.
  
  
  RESULTS
  Fully breastfed neonates received 1.6% (range 0.2%-9%) of the maternal weight-adjusted hydrocodone bitartrate dosage. When combined with hydromorphone, the total median opiate dosage from breast milk is 0.7% of a therapeutic dosage for older infants. Most mothers excreted little to no hydromorphone into breast milk.
  
  
  CONCLUSIONS
  Standard postpartum dosages of hydrocodone bitartrate appear to be acceptable to use in women nursing newborns. Prolonged use of high dosages is not advisable.
authors.affiliation: From the Department of Pharmacy and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego Medical Center, San Diego, California; the Pediatric Pharmacology Research Unit, University of California, San Diego, San Diego, California; and the Department of Pediatrics, Division of Neonatology, School of Medicine, University of California, San Diego, California.
authors.forename: Jason B
authors.initials: JB
authors.lastname: Sauberan
authors.forename: Philip O
authors.initials: PO
authors.lastname: Anderson
authors.forename: James R
authors.initials: JR
authors.lastname: Lane
authors.forename: Sally
authors.initials: S
authors.lastname: Rafie
authors.forename: Nancy
authors.initials: N
authors.lastname: Nguyen
authors.forename: Steven S
authors.initials: SS
authors.lastname: Rossi
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Stellwagen
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000032:analysis / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006853:Hydrocodone / Q000032:analysis / Q000493:pharmacokinetics* / Q000627:therapeutic use; D004091:Hydromorphone / Q000032:analysis / Q000493:pharmacokinetics* / Q000627:therapeutic use; D008895:Milk, Human / Q000737:chemistry*; D010146:Pain / Q000188:drug therapy; D049590:Postpartum Period; D011247:Pregnancy; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D006853:Hydrocodone; D004091:Hydromorphone