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

Ibuprofen

May 13, 2018 (Very Low Risk)

A non-steroidal anti-inflammatory indicated in the treatment of fever, pains, rheumatoid arthritis and other rheumatic complaints.
Oral, intravenous and topical administration (cutaneous or vaginal), every 6 to 8 hours.

Its pharmacokinetic data (high percentage of protein binding, acidic character and short half-life) explain the tiny or zero transfer of milk observed (Rigourd 2014, Walter 1997, Townsend 1984, Albert 1984, Weibert 1982).

No problems have been observed in infants whose mothers were taking it (Walter 1997, Ito 1993, Weibert 1982).

A medication commonly used in pediatrics. Its use is authorized from 6 months of age. The dose that an infant can receive through breastmilk is hundreds of times inferior to the therapeutic dose given to an infant (Rigourd 2014, Walter 1997).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
List of essential WHO medications: compatible with breastfeeding (WHO/UNICEF, 2002).

Expert authors and medical associations consider it compatible with breastfeeding (Reece 2017, Bordini 2016, Noviani 2016, Davanzo 2014, Sachs 2013, Worthington 2013, Hutchinson 2013, Rowe 2013, Amir 2011, Chen 2010, Risser 2009, Østensen 2007, Spigset 2000 , Janssen 200, Nice 2000, Mitchell 1999, Goldsmith 1989, Needs 1985).

It is regarded as the analgesic of choice for breastfeeding mothers (Worthington 2013, Østensen 2007, Nice 2000). 

Alternatives

We do not have alternatives for Ibuprofen 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

  • Ibuprofen Arginine
  • Ibuprofen Lysine

Writings

  • Ιβουπροφαίνη (Greek)
  • إيبوبروفان (Arabic)
  • Ибупрофен (Cyrillic)
  • 布洛芬 (Chinese)
  • イブプロフェン (Japanese)
  • Ibuprofène (French)
  • C13 H18 O2 (Molecular formula)
  • 2-(4-Isobutylphenyl)propionic acid (Chemical name)
  • C01EB16; G02CC01; M01AE01; M02AA13; R02AX02 (ATC Code/s)

Drug trade names

References

  1. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeeding Medicine. 2017 Full text (link to original source) Full text (in our servers)
  2. Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016Abstract Full text (link to original source) Full text (in our servers)
  3. Noviani M, Wasserman S, Clowse ME. Breastfeeding in mothers with systemic lupus erythematosus. Lupus. 2016Abstract
  4. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014Abstract
  5. Rigourd V, de Villepin B, Amirouche A, Bruneau A, Seraissol P, Florent A, Urien S, Magny JF, Serreau R. Ibuprofen concentrations in human mature milk--first data about pharmacokinetics study in breast milk with AOR-10127 "Antalait" study. Ther Drug Monit. 2014Abstract
  6. Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ; Canadian Headache Society Acute Migraine Treatment Guideline Development Group.. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013Abstract
  7. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013Abstract Full text (link to original source) Full text (in our servers)
  8. Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ; Canadian Headache Society Acute Migraine Treatment Guideline Development Group. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013Abstract Full text (in our servers)
  9. Hutchinson S, Marmura MJ, Calhoun A, Lucas S, Silberstein S, Peterlin BL. Use of common migraine treatments in breast-feeding women: a summary of recommendations. Headache. 2013Abstract Full text (link to original source) Full text (in our servers)
  10. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  11. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  12. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010Abstract Full text (link to original source) Full text (in our servers)
  13. Risser A, Donovan D, Heintzman J, Page T. NSAID prescribing precautions. Am Fam Physician. 2009Abstract Full text (link to original source) Full text (in our servers)
  14. Østensen M, Motta M. Therapy insight: the use of antirheumatic drugs during nursing. Nat Clin Pract Rheumatol. 2007Abstract
  15. 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)
  16. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  17. Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Arch Intern Med. 2000Abstract Full text (link to original source) Full text (in our servers)
  18. Spigset O, Hägg S. Analgesics and breast-feeding: safety considerations. Paediatr Drugs. 2000Abstract
  19. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000Abstract
  20. Mitchell JL. Use of cough and cold preparations during breastfeeding. J Hum Lact. 1999Abstract
  21. Walter K, Dilger C. Ibuprofen in human milk. Br J Clin Pharmacol. 1997Abstract
  22. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993Abstract
  23. Goldsmith DP. Neonatal rheumatic disorders. View of the pediatrician. Rheum Dis Clin North Am. 1989Abstract
  24. Needs CJ, Brooks PM. Antirheumatic medication during lactation. Br J Rheumatol. 1985Abstract
  25. Townsend RJ, Benedetti TJ, Erickson SH, Cengiz C, Gillespie WR, Gschwend J, Albert KS. Excretion of ibuprofen into breast milk. Am J Obstet Gynecol. 1984Abstract
  26. Albert KS, Gernaat CM. Pharmacokinetics of ibuprofen. Am J Med. 1984Abstract
  27. Weibert RT, Townsend RJ, Kaiser DG, Naylor AJ. Lack of ibuprofen secretion into human milk. Clin Pharm. 1982Abstract