Droperidol and Breastfeeding

Summary of use during lactation

Because little information is available on the long-term use of droperidol during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Single-dose or short-term use during breastfeeding, such as during surgery, is unlikely to adversely affect the breastfed infant, especially if the infant is older than 2 months.[1] When multiple doses are given to the mother, monitor the infant for drowsiness, especially in younger, exclusively breastfed infants and when using combinations of psychotropic drugs.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

A randomized study compared the breastfed infants born by cesarean section whose mothers received either morphine or morphine plus droperidol by patient-controlled analgesia postoperatively. On days 1 and 2 of life, the infants whose mothers received droperidol had a lower neonatal neurologic and adaptive capacity score (NACS) than those who received morphine only.[2] One breastfed (extent not stated) infant whose mother was taking droperidol had a somewhat decreased intellectual development on testing, but her mother had also taken olanzapine, clonazepam, sertraline, thioridazine and valproic acid while breastfeeding.[3]

Effects on lactation and breastmilk

Hyperprolactinemia has been reported in patients taking long-term droperidol and after short-term use during surgical procedures.[4-7] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.

References

1. Spigset O. Anaesthetic agents and excretion in breast milk. Acta Anaesthesiol Scand 1994;38:94-103.8171959 PubMed
2. Bonhomme V, Brichant JF, Wuilmart M, et al. Droperidol reduces nausea after caesarean section but alters the neurological status of the breastfed infants. Anesthesiology 2002;96:A1044.
3. Gardiner SJ, Kristensen JH, Begg EJ, et al. Transfer of olanzapine into breast milk, calculation of infant drug dose, and effect on breast-fed infants. Am J Psychiatry 2003;160:1428-31.12900304 PubMed
4. Langer G, Puhringer W. Haloperidol and droperidol treatment in schizophrenics. Clinical application of the "prolactin-model". Acta Psychiatr Belg 1980;80:574-83.7234451 PubMed
5. Smith S, Wheeler MJ, Murray R, et al. The effects of antipsychotic-induced hyperprolactinaemia on the hypothalamic-pituitary-gonadal axis. J Clin Psychopharmacol 2002;22:109-14.11910254 PubMed
6. Naito Y, Tamai S, Fukata J, et al. Comparison of endocrinological stress response associated with transvaginal ultrasound-guided oocyte pick-up under halothane anaesthesia and neuroleptanaesthesia. Can J Anaesth 1989;36:633-6.2555076 PubMed
7. Jullien Y, de Rodez M, Bonardet A, et al. Comparison of postoperative blood levels of prolactin and somatotropin after two methods of anesthesia. Ann Anesthesiol Fr 1980;21:459-66.6110401 PubMed