Potential Consequences of Codeine Use in Lactating Mothers

Madidi P. , Ross C.J.D. , Hayden M.R. . Pharmacogenetics of neonatal opioid toxicity following maternal use of codeine during breastfeeding: A case-control study. Clin Pharmacol Ther. 2009; 85(1): 31–35.

Lam J. , Kelly L. , Ciszkowski C. . Central nervous system depression of neonates breastfed by mothers receiving oxycodone for postpartum analgesia. J Pediatr. 2012; 160: 33–37.

Kelly L.E. , Chaudhry S.A. , Rieder M.J. . A clinical tool for reducing central nervous system depression among neonates exposed to codeine through breast milk. PLoS One. 2013 8(7): e70073.

Bernard S. , Neville K.A. , Nguyen A.T. . Interethnic differences in genetic polymorphisms of CYP2D6 in the US population: Clinical implications. Oncologist. 2006; 11: 126–35.

Mulugeta L. Pharmacogenetics of codeine [PowerPoint slides]. 2013. http://www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/pediatricadvisorycommittee/ucm343582.pdf. Accessed August 15, 2015.

US Food and Drug Administration. Use of codeine products in nursing mothers – questions and answers. 2007. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm118113.htm. Accessed August 15, 2015.

Acetaminophen and codeine phosphate oral solution [package insert]. Amityville, NY: Hi-Tech Pharmacal Co. Inc.; March 2009.

Madidi P. , Moretti M. , Djokanovic N. . Guidelines for maternal codeine use during breastfeeding. Can Fam Physician. 2009; 55(11): 1077–1078.

Madidi P. , Shirazi F. , Walter F.G. . Establishing causality of CNS depression in breastfed infants following maternal codeine use. Pediatr Drugs. 2008; 10(6): 399–404.

Koren G. , Caims J. , Chitayat D. . Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet. 2006; 368: 704.

Gasche Y. , Daali Y. , Fathi M. . Codeine intoxication associated with ultrarapid CYP2D6 metabolism. N Eng J Med. 2004; 351: 2827–2831.

Willman S. , Edginton A.N. , Coboeken K. . Risk to breastfed neonate from codeine treatment to the mother: A quantitative mechanistic modeling study. Nature. 2009; 86(6): 634–643.

Lazaryan M. , Shasha-Zigelman C. , Dagan Z. . Codeine should not be prescribed for breastfeeding others or children under the age of 12. Acta Pediatr. 2015; 104: 550–556.

Madidi P. , Koren G. , Cairns J. . Safety of codeine during breastfeeding: Fatal morphine poisoning in the breastfed neonate of a mother prescribed codeine. Can Fam Physician. 2007; 53: 33–35.