Etomidate and Breastfeeding

Summary of use during lactation

Amounts of etomidate in milk are very small and decrease rapidly. Existing data indicate that no waiting period is required before resuming breastfeeding after etomidate anesthesia. Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure. Monitor the infant for sedation and poor feeding.

Drug levels in milk and infant serum

Maternal Levels. Twenty women undergoing cesarean section received 0.3 mg/kg of etomidate intravenously for induction of anesthesia. Average colostrum levels were 79.3 mcg/L (range 0 to 420 mcg/L) at 30 minutes and 16.2 mcg/L (range 0 to 60 mcg/L) at 2 hours after the dose. Etomidate was not detected in any colostrum samples 4 hours after the dose.[1] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

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

Effects on lactation and breastmilk

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

Alternative drugs to consider

Dexmedetomidine, Methohexital, Propofol, Thiopental

References

1. Esener Z, Sarihasan B, Guven H, et al. Thiopentone and etomidate concentrations in maternal and umbilical plasma, and in colostrum. Br J Anaesth 1992;69:586-8.1467101 PubMed