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Safety of codeine during breastfeeding: fatal morphine poisoning in the breastfed neonate of a mothe

Safety of codeine during breastfeeding: fatal morphine poisoning in the breastfed neonate of a mothe

  1. Jatelka
    Canadian Family Physician 2007 Jan;53(1):33-5

    Madadi P (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Koren G (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Cairns J (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Chitayat D (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Gaedigk A (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Leeder JS (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Teitelbaum R (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Karaskov T (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Aleksa K (http://www.drugs-forum.com/sites/en...l.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).

    QUESTION: Recently a newborn died from morphine poisoning when his mother used codeine while breastfeeding. Many patients receive codeine for postlabour pain. Is it safe to prescribe codeine for nursing mothers? ANSWER: When a mother is an ultrarapid metabolizer of cytochrome P450 2D6, she produces much more morphine when taking codeine than most people do. In this situation, newborns might be exposed to toxic levels of morphine when breastfeeding. Options to reduce this risk include discontinuing codeine after 2 to 3 days of use and being aware of symptoms of potential opioid toxicity in both mothers and newborns.