Meperidine Pregnancy and Breastfeeding Warnings
Meperidine Pregnancy Warnings
Meperidine has been assigned to pregnancy category C by the FDA. It has been frequently used in pregnancy and during labor. Meperidine and normeperidine cross the placenta very rapidly and may cause respiratory depression and lower psychophysiologic test scores in newborns if it is administered to the mother shortly before delivery. Infants of chronic users may experience withdrawal. There are no controlled data in human pregnancy. Meperidine should only be given during pregnancy if clearly needed.
Meperidine Breastfeeding Warnings
Meperidine is excreted into human milk. One study has reported an increased incidence of apneic events in breastfed infants whose mothers take opioids (including meperidine) while nursing. Due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
One study has reported that normeperidine levels are persistently elevated in breast milk. The elevation in metabolite levels has been suggested as an explanation for the fact that neonates whose mothers are treated with meperidine exhibit greater neurobehavioral depression than neonates whose mothers are treated with morphine. One report on concentrations in breast milk of medications used during general anesthesia has stated that meperidine was present in both milk and blood during the recovery period but not at 24 hours. This report stated that infant exposure indices ranged from 1.2% to 3.5% for meperidine. Therefore, the authors concluded that the amount of meperidine excreted into breast milk when used for general anesthesia does not warrant interruption in breast-feeding.
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