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

Naproxen

February 28, 2018 (Low Risk)

Oral dosage twice daily.

Low excreted into breast milk (Reece-Stremtan2017, Østensen 2007, Jamali 1982). However, somnolence in 10% of breastfed infants has been reported (Ito 1993).

A case of acute anemia due to hemorrhage by coagulation disturbance in an one week aged infant (Fidalgo 1989).

Long-term use while breastfeeding (Davanzo 2014, Sachs 2013) or in case of newborn jaundice is not recommended because a competitive effect on liver metabolism has been shown (Risser 2009, Janssen 2000).
Short-term (1 week) or sporadic use has a low risk (Jamali 1982).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

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.

Synonyms

  • Naproxen Sodium

Writings

  • ναπροξένη (Greek)
  • نابروكسان (Arabic)
  • Напроксен (Cyrillic)
  • 萘普生 (Chinese)
  • ナプロキセン (Japanese)
  • C14 H14 O3 (Molecular formula)
  • (+)-2-(6-Methoxy-2-naphthyl)propionic acid (Chemical name)
  • G02CC02 (ATC Code/s)
  • M01AE02 (ATC Code/s)
  • M02AA12 (ATC Code/s)

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. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014Abstract
  3. 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)
  4. 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)
  5. 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)
  6. 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)
  7. 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)
  8. Davies NM, Anderson KE. Clinical pharmacokinetics of naproxen. Clin Pharmacokinet. 1997Abstract
  9. 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
  10. Fidalgo I, Correa R, Gómez Carrasco JA, Martínez Quiroga F. Anemia aguda, rectorragia y hematuria asociadas a la ingestión de naproxen. [Acute anemia, rectorrhagia and hematuria caused by ingestion of naproxen]. An Esp Pediatr. 1989Abstract
  11. Fidalgo I, Correa R, Gómez Carrasco JA, Martínez Quiroga F. [Acute anemia, rectorrhagia and hematuria caused by ingestion of naproxen]. An Esp Pediatr. 1989Abstract
  12. Jamali F, Stevens DR. Naproxen excretion in milk and its uptake by the infant. Drug Intell Clin Pharm. 1983Abstract
  13. Brogden RN, Pinder RM, Sawyer PR, Speight TM, Avery GS. Naproxen: a review of its pharmacological properties and therapeutic efficacy and use. Drugs. 1975Abstract