Can You Breastfeed On Percocet?

In our latest question and answer, the pharmacist discusses whether or not it is safe to breastfeed while taking Percocet.

Jul 15, 2018

Amber asked

I got prescribed Percocet 5 mg and I was wondering how long after taking Percocet 5 mg is it safe to breastfeed? I don’t want to harm my little one at all.

Answer

Percocet contains two drugs:

  • Acetaminophen
  • Oxycodone

Acetaminophen, commonly known as the active ingredient in Tylenol, has not been associated with any observable changes in nursing infants of mothers that took acetaminophen while breast-feeding. The American Academy of Pediatrics (AAP) regard acetaminophen as a maternal medicine that is usually compatible with breast-feeding.

Oxycodone however, the other component of Percocet, generally isn't recommended to be taken if breastfeeding because of the possibility of sedation and/or respiratory depression in the baby. The AAP has not evaluated the use of oxycodone in breast-feeding women but several studies have noted the high risk of respiratory depression and potential withdrawal symptoms that could occur with prolonged use.

If oxycodone is used by a breast-feeding mother, the infant should be monitored for sedation, respiratory depression, and changes in feeding patterns.

How Long To Wait To Breastfeed After Taking Percocet

In terms of how long to wait to breastfeed after taking a dose of Percocet, this will vary by individual as certain factors like liver function can greatly affect how long it takes for our bodies to eliminate medication.

As we are most concerned about oxycodone in regard to breastfeeding, we will take a look at how long it takes to be metabolized and eliminated from the body.

The half-life of oxycodone, according to the prescribing information for Percocet, is on average 3.51 hours (± 1.43 hours as the standard deviation). In general, it takes around 5 to 6 half-lives for a drug to be completely eliminated from the body. Therefore, on average, it will take around 15-30 hours for the oxycodone in Percocet to be eliminated. Remember however, that there are certain factors (e.g. genetic variations, liver functions) that could prolong this time.

It important to note that sometimes, drug elimination rates based on half-life don't always directly correlate to drug concentrations in the breast milk. In fact, there have been studies that have shown that oxycodone can be detected in the breast milk for up to 72 hours after taking oxycodone. Per one study:

"Oxycodone is concentrated in human breast milk up to 72‐h post‐partum [after given for pain for cesarean section]. Breastfed infants may receive > 10% of a therapeutic infant dose."
It is important to discuss with your doctor how to best manage your pain if you are breastfeeding. There is a risk that oxycodone may be present in the breast milk, even one to two days after last dosing. Breast milk concentrations of oxycodone are likely to be low after 24 hours, but If you do breast feed while taking oxycodone, it is important to monitor for certain side effects in an infant such as constipation, sedation and respiratory depression.

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