Granisetron use while Breastfeeding

Summary of Use during Lactation

No information is available on the use of granisetron during breastfeeding. Until more data become available, granisetron should be used with caution during breastfeeding. An alternate drug may be preferred.

Drug Levels

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

A woman nursing an 8-month-old infant 6 to 8 times daily was admitted to the hospital for an appendectomy. During the procedure she received granisetron, cefazolin, ketorolac, rocuronium, succinylcholine, and sufentanil. The patient also received 2 boluses of intravenous propofol of 150 mg followed shortly thereafter by a 50 mg dose. Postoperatively, she was receiving acetaminophen, cefazolin, ibuprofen, and pantoprazole, as well as oxycodone and dimenhydrinate as needed. Twenty-two hours after the procedure, the mother extracted milk for the first time and noted it to be light green in color. Analysis of the green milk using a nonvalidated assay detected no propofol. The green color faded and was absent by postoperative day 4 when she resumed breastfeeding. The authors judged that the green color was possibly caused by propofol or one of its metabolites.[1]

Alternate Drugs to Consider

Ondansetron

References

1.

Rainone A, Delucilla L, Elofer S, et al. Propofol-induced green breast milk: A case report. Can J Hosp Pharm. 2018;71:389–91. [PMC free article: PMC6306180] [PubMed: 30626986]

Substance Name

Granisetron

CAS Registry Number

109889-09-0

Drug Class

Breast Feeding

Lactation

Antiemetics

Gastrointestinal Agents

Serotonin Antagonists

Serotonin 5-HT3 Receptor Antagonists