Is Adrenaline compatible with breastfeeding? Do we have alternatives for Adrenaline?

Adrenaline

November 15, 2015 (Very Low Risk)

Used as a systemic drug for cardiac resuscitation and locally in topical anesthetic preparations, epidural anesthesia, eye drops (mydriatic), and nasal drops (vasoconstrictor).

At last update no published data on excretion in breast milk were found.
Its rapid metabolism (short Tmax and T½) makes it unlikely an excretion into milk in significant amounts.

It is destroyed in the gastrointestinal tract. The low oral-bioavailability makes its levels into infant's plasma, that would be absorbed from ingested breast milk, be nil or negligible.

Maintained high intravenous doses decrease milk production by interfering with the secretion of prolactin especially the early postpartum-weeks, because when breastfeeding is well established, prolactin levels do not correlate with milk production any longer.

No problems related to lactation have been observed due to epidural anesthesia in which adrenaline is used.

Alternatives

We do not have alternatives for Adrenaline since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Epinephrine

Writings

  • إيبينيفرين (Arabic)
  • Эпинефрин (Cyrillic)
  • 肾上腺素 (Chinese)
  • アドレナリン (Japanese)
  • C9H13NO3 (Molecular formula)

References

  1. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
  2. Shank JJ, Olney SC, Lin FL, McNamara MF. Recurrent postpartum anaphylaxis with breast-feeding. Obstet Gynecol. 2009Abstract
  3. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  4. Chang ZM, Heaman MI. Epidural analgesia during labor and delivery: effects on the initiation and continuation of effective breastfeeding. J Hum Lact. 2005Abstract
  5. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  6. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000Abstract
  7. Nicoletti I, Filipponi P, Sfrappini M, Fedeli L, Petrelli S, Gregorini G, Santeusanio F, Brunetti P. Catecholamines and pituitary function. I. Effects of catecholamine synthesis inhibition and subsequent catecholamine infusion on gonadotropin and prolactin serum levels in normal cycling women and in women with hyperprolactinemic amenorrhea. Horm Res. 1984Abstract