It is a well known fact that breastfeeding is best source of nutrition for infants. Breast milk provides minerals, vitamins and antibodies in most acceptable format when they need it. Nutrition taken by mother passes to breast-milk and same thing applies to medicines taken by mothers. Not all drugs cause problem for baby but some do. Lets analyze if Morphine Sulfate Tablet, Extended Release is safe for baby while breastfed.
What is Morphine Sulfate Tablet, Extended Release used for?
Morphine sulfate extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.(1) Limitations of Use Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve morphine sulfate extended-release tablets for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain. (1) Morphine sulfate extended-release tablets are not indicated as an as-needed (prn) analgesic. (1) Morphine sulfate extended-release tablets are indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. Limitations of Use Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve morphine sulfate extended-release tabletsfor use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain. Morphine sulfate extended-release tabletsare not indicated as an as-needed (prn) analgesic.
What are the risk associated with Morphine Sulfate Tablet, Extended Release usage while breastfeeding? What precautions shall I take while using it in breastfeeding?
Morphine Sulfate Tablet, Extended Release contains only one active ingredient that is Morphine sulfate. We have analyzed the usage of Morphine sulfate in breastfeeding and our analysis suggest that Morphine sulfate poses Low risk for infant while breastfeeding and hence Morphine Sulfate Tablet, Extended Release itself shall be considered Low risk item for breastfeeding.
Statement of Manufacturer/Labeler about breastfeeding usage
8.3 Nursing Mothers Morphine is excreted in breast milk, with a milk to plasma morphine AUC ratio of approximately 2.5:1. The amount of morphine received by the infant varies depending on the maternal plasma concentration, the amount of milk ingested by the infant, and the extent of first pass metabolism. Withdrawal signs can occur in breast-feeding infants when maternal administration of morphine is stopped. Because of the potential for adverse reactions in nursing infants from morphine sulfate extended-release tablets, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Morphine Sulfate Tablet, Extended Release Breastfeeding Analsys
Low RiskCAS Number: 57-27-2
Excretion into breast milk is low (even lower when administered through Epidural Anesthesia). In addition, a low oral bioavailability makes that the amount present in the infant's plasma due to absorption from milk by the gut is low. Even though, level of drug has been found in the plasma of infants from treated mothers, harmful effects in the infants were not reported. Levels in the milk are lower and side-effects are fewer among infants whose mothers were treated with Morphine than with Pethidine. Some authorities consider Morphine as the elective opioid medication for breastfeeding mothers. Analgesia used during the birth process is related to a brief delayed of stage II of Lactogenesis (milk come-in). Morphine increases Prolactin level and may decrease Oxytocin level, but it would not be determinant for already established lactations. Avoidance of repetitive or chronic use and follow-up for somnolence and adequacy of infant nourishment is recommended. Bed-sharing should be avoid whenever this medication is used by parents. The American Academy of Pediatrics rates it as compatible with breastfeeding.
Morphine Sulfate Tablet, Extended Release Breastfeeding Analsys - 2
CAS Number: 57-27-2
Epidural morphine given to mothers for postcesarean section analgesia results in trivial amounts of morphine in their colostrum and milk. Intravenous or oral doses of maternal morphine in the immediate postpartum period result in higher milk levels than with epidural morphine. Labor pain medication may delay the onset of lactation. Maternal use of oral narcotics during breastfeeding can cause infant drowsiness, central nervous system depression and even death, although low-dose morphine might be preferred over other opiates.[1] 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 morphine to a 2 to 3 days at a low dosage with close infant monitoring, especially in the outpatient setting.[2] If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately.
What should I do if already breastfed my kid after using Morphine Sulfate Tablet, Extended Release?
During whole lactation period you shall first discuss with your doctor and then together you shall decide whether you shall take that drug or not however if you have already taken Morphine Sulfate Tablet, Extended Release then you shall inform your doctor, But you should not be worried too much as Morphine Sulfate Tablet, Extended Release comes in category of low risk drug.
My health care provider has asked me to use Morphine Sulfate Tablet, Extended Release, what to do?
Though Morphine Sulfate Tablet, Extended Release dose not comes in category of safe drugs rather it comes in category of low risk but if your doctor is aware that you are breastfeeding your baby and has still recommended it then its advantages must be outweighing the risks.
If I am using Morphine Sulfate Tablet, Extended Release, will my baby need extra monitoring?
Not much
Who can I talk to if I have questions about usage of Morphine Sulfate Tablet, 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
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