FDA Has a Warning for Nursing Mothers Regarding Medications with Codine

By Regina Sass, published Aug 17, 2007
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The U.S. Food and Drug Administration is warning nursing mothers about the use of using medications such as cold medicines containing codeine due to the fact that the babies may be at an increased risk of morphine overdose, especially if the mother is an ultra-rapid metabolizer of codeine.

One 13 day old baby has died from morphine overdose and his mother had taken small doses of codeine to treat episiotomy pain and the levels of morphine in the mother's milk was exceedingly high. A genetic test determined that she was in fact an ultra-rapid metabolizer of codeine.

Codeine is found in both prescription and non- prescription medications. They are generally used as pain relievers of cough medicines. The body will convert, or metabolize, a portion of the codeine into morphine. However some people have a genetic make up that makes them metabolize the codeine at a much faster rate that in other people.

People with this genetic makeup are called ultra-rapid metabolizers and they are much more likely to have greater levels of morphine in their blood after taking medicines with codeine. Mothers who are ultra-rapid metabolizers have a tendency to the levels of morphine in breast milk

The FDA is advising doctors to prescribe products containing codeine to nursing mothers only in the lowest possible doses and for the shortest period of time. And mothers are urged to consult with a physician before taking any medications containing cocaine.

Codeine is thought to be the safest of all the narcotic pain relievers for nursing women and their babies and it has been used safely for years, but it is important for mothers and doctors as well to be aware of the possible risk to some patients and to that end, the FDA is going to require manufactures of such medications to include the information bout this risk in all the drug package insert information.

There are signs to look for in a baby to determine if he or she is in danger of overdosing. Signs include increased sleepiness, difficulty breastfeeding, breathing difficulties or limpness

FDA Has a Warning for Nursing Mothers Regarding Medications with Codine
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