Pentazocine and Breastfeeding

Summary of use during lactation

No information is available on the use of pentazocine during breastfeeding. Maternal use of oral opioids during breastfeeding can cause infant drowsiness, which may progress to rare but severe central nervous system depression. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. If pentazocine is required by the mother of a newborn, it is not a reason to discontinue breastfeeding; however, once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of pentazocine to 2 to 3 days at a low dosage with close infant monitoring. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. Combination products with naloxone carry the same considerations. Withdrawal symptoms can occur in breastfed infants when maternal administration of an opioid analgesic is stopped, or when breastfeeding is stopped. Other agents are preferred over pentazocine during breastfeeding.[1]

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

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

Effects on lactation and breastmilk

Pentazocine can increase serum prolactin.[2,3] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternative drugs to consider

Acetaminophen, Butorphanol, Fentanyl, Hydromorphone, Ibuprofen, Morphine

References

1. Sachs, HC, The Committee on Drugs. The transfer of drugs and therapeutics into human breast milk: An update on selected topics [Reaffirmed May, 2018]. Pediatrics 2013;132:e796-809.23979084 PubMed
2. Rolandi E, Barreca T. Effects of two analgesic opiates (methadone and pentazocine) on the serum prolactin levels in breast cancer. Acta Endocrinol (Copenh) 1978;88:452-4.581016
3. Manner T, Kanto J, Scheinin H, et al. Meptazinol and pentazocine: Effects on prolactin, growth hormone and vasopressin levels in plasma. Pharmacol Toxicol 1987;61:301-4.3438224 PubMed