Lazanda | Fentanyl Citrate Spray while Breastfeeding
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 Lazanda | Fentanyl Citrate Spray is safe for baby while breastfed.

What is Lazanda | Fentanyl Citrate Spray used for?


Lazanda (fentanyl) nasal spray is indicated for the management of breakthrough pain in cancer patients 18 years of age and older who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. Patients considered opioid tolerant are those who are taking at least: 60 mg of oral morphine/day, 25 mcg of transdermal fentanyl/hour, 30 mg oral oxycodone/day, 8 mg oral hydromorphone/day, 25 mg oral oxymorphone/day, or an equianalgesic dose of another opioid for a week or longer. Patients must remain on around-the-clock opioids when taking Lazanda. Lazanda is contraindicated for patients who are not already tolerant to opioids because life-threatening respiratory depression and death could occur in patients not taking chronic opioids. For this reason, Lazanda is contraindicated in the management of acute or postoperative pain, including headache/migraine, or dental pain. [4] Lazanda is intended to be prescribed only by healthcare professionals who are knowledgeable of and skilled in the use of Schedule II opioids to treat cancer pain. Lazanda is an opioid agonist indicated for the management of breakthrough pain in cancer patients 18 years of age and older who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. [1] Limitations of Use: Lazanda may be dispensed only to patients enrolled in the TIRF REMS Access program. Limitations of Use: As a part of the TIRF REMS Access program, Lazanda may be dispensed only to outpatients enrolled in the program. [see Warnings and Precautions (5.10) ]. For inpatient administration of Lazanda (e.g. hospitals, hospices, and long-term care facilities that prescribe for inpatient use), patient enrollment is not required.

Lazanda | Fentanyl Citrate Spray while breastfeeding safe or not? Can there be any side effects for infant while using it during breastfeeding?

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

Statement of Manufacturer/Labeler about breastfeeding usage
8.3 Nursing Mothers Fentanyl is excreted in human milk; therefore, do not use Lazanda in women who are nursing because of the risk of sedation and/or respiratory depression in their infants. Symptoms of opioid withdrawal may occur in infants upon cessation of nursing by women using Lazanda.

Lazanda | Fentanyl Citrate Spray Breastfeeding Analsys


Fentanyl while Breastfeeding

Safe

CAS Number: 437-38-7

Is Lazanda | Fentanyl Citrate Spray safe while breastfeeding

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.


Lazanda | Fentanyl Citrate Spray 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.



What should I do if already breastfed my kid after using Lazanda | Fentanyl Citrate Spray?

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 Lazanda | Fentanyl Citrate Spray and have used it then do not panic as Lazanda | Fentanyl Citrate Spray 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 Lazanda | Fentanyl Citrate Spray, is it safe?

Definitely, Lazanda | Fentanyl Citrate Spray is safe in lactation for baby. No wonder your doctor has recommended it.


If I am using Lazanda | Fentanyl Citrate Spray, will my baby need extra monitoring?

No extra baby monitoring required while mother is using Lazanda | Fentanyl Citrate Spray


Who can I talk to if I have questions about usage of Lazanda | Fentanyl Citrate Spray 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