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

Ketoprofen

May 13, 2018 (Very Low Risk)

Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID).
Oral, rectal, intramuscular, intravenous and topical administration every 6 to 12 hours.

It is excreted in breastmilk in clinically negligibe amounts (Jacqz-Aigrain 2007) and authors consider it compatible with breastfeeding (Davanzo 2014, Jacqz-Aigrain 2007, Nice 2000).

Its high percentage of protein binding explains the very small transfer to milk observed.

In a French pharmacovigilance study, several possible cases, unconfirmed, were found of the implication of ketoprofen in certain adverse effects in the infant (Soussan 2014). Its pharmacokinetics makes its involvement unlikely.

The small dose and the low plasma absorption of most topical dermatological preparations make transfer to breastmilk in significant amounts unlikely. Systemic bioavailability is 5% (AEMPS 2016).

Most non-steroidal anti-inflammatories may increase jaundice, so it is preferable to avoid them during the neonatal period in mothers of infants with jaundice. (Janssen 2000).

Alternatives

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.

Writings

  • Κετοπροφαίνη (Greek)
  • كيتوبروفان (Arabic)
  • Кетопрофен (Cyrillic)
  • 酮洛芬 (Chinese)
  • ケトプロフェン (Japanese)
  • Kétoprofène (French)
  • Ketoprofè (Catalan)
  • C16 H14 O3 (Molecular formula)
  • (RS)-2-(3-Benzoylphenyl)propionic acid (Chemical name)
  • M01AE03 (ATC Code/s)
  • M02AA10 (ATC Code/s)

References

  1. AEMPS. Ketoprofeno. Ficha técnica. 2017 Full text (in our servers)
  2. AEMPS. Ketoprofeno (uso tópico). Ficha técnica. 2016 Full text (in our servers)
  3. Soussan C, Gouraud A, Portolan G, Jean-Pastor MJ, Pecriaux C, Montastruc JL, Damase-Michel C, Lacroix I. Drug-induced adverse reactions via breastfeeding: a descriptive study in the French Pharmacovigilance Database. Eur J Clin Pharmacol. 2014Abstract
  4. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014Abstract
  5. Jacqz-Aigrain E, Serreau R, Boissinot C, Popon M, Sobel A, Michel J, Sibony O. Excretion of ketoprofen and nalbuphine in human milk during treatment of maternal pain after delivery. Ther Drug Monit. 2007Abstract
  6. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000Abstract
  7. De Graeve J, Frankinet C, Gielen JE. A quantitative selected ion monitoring assay for ketoprofen determination in human biological fluids. Biomed Mass Spectrom. 1979Abstract