Epinephrine use while Breastfeeding
Drugs containing Epinephrine: EpiPen, Adrenalin, EpiPen 2-Pak, Auvi-Q, EpiPen Auto-Injector, Asthmahaler, EpiPen Jr, Vivacaine, Xylocaine Dental, Septocaine, Show all 57 »Primatene Mist, Adrenaclick, Glaucon, Epi EZ Pen, EpiPen JR 2-Pak, Raphon, Xylocaine with Epinephrine, LidoSite, Articadent, EPIsnap, Citanest Forte, Xylocaine-MPF-Epinephrine, Xylocaine with Epinephrine Dental Cartridges, Xylocaine HCl with Epinephrine, Lignospan, P2E1, E-Pilo-6, P6E1, Lignospan Forte, E-Pilo-4, E-Pilo-2, P4E1, P1E1, E-Pilo-1, Octocaine 100, Lets Kit, P3E1, Sus-Phrine Injection, Ana-Kit, Epifrin, Eppy/N, Sensorcaine with Epinephrine, Marcaine HCl with Epinephrine, Orabloc, Zorcaine, Sensorcaine-MPF with Epinephrine, Epinal, Twinject, Medihaler-Epi, Bronkaid Mist, Adrenalin Topical, Bronchial Mist with Pump, Bronitin, Adrenalin Chloride, Ana-Guard, EpiPen JR Auto-Injector, Duranest-MPF-Epinephrine
Epinephrine Levels and Effects while Breastfeeding
Summary of Use during Lactation
No information is available on the use of epinephrine during breastfeeding. Because of its poor oral bioavailability and short half-life, any epinephrine in milk is unlikely to affect the infant. High intravenous doses of epinephrine might reduce milk production or milk letdown. Low-dose epidural, topical, inhaled or ophthalmic epinephrine are unlikely to interfere with breastfeeding. To substantially diminish the effect of the drug after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
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
Relevant published information in nursing mothers was not found as of the revision date. Intravenous epinephrine infusion in nonnursing subjects and in women with hyperprolactinemia decreases serum prolactin concentrations. Animal data indicate that intraarterial epinephrine can decrease serum oxytocin and inhibit milk ejection. However, low-dose infusion of epinephrine as part of epidural analgesia does not impair breastfeeding in nursing mothers. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
An Egyptian study compared lidocaine 2% (n = 75) to lidocaine 2% plus epinephrine 1:200,000 (n = 70) as a wound infiltration following cesarean section. Patients who received epinephrine in combination with lidocaine began breastfeeding at 89 minutes following surgery compared to 132 minutes for those receiving lidocaine alone. The difference was statistically significant.
1. Nicoletti I, Filipponi P, Sfrappini M et al. Catecholamines and pituitary function. I. Effects of catecholamine synthesis inhibition and subsequent catecholamine infusion on gonadotropin and prolactin serum levels in normal cycling women and in women with hyperprolactinemic amenorrhea. Horm Res. 1984;19:158-70. PMID: 6425187
2. Gorewit RC, Aromando MC. Mechanisms involved in the adrenalin-induced blockade of milk ejection in dairy cattle. Proc Soc Exp Biol Med. 1985;180:340-7. PMID: 4048172
3. Song SL, Crowley WR, Grosvenor CE. Evidence for involvement of an adrenal catecholamine in the beta-adrenergic inhibition of oxytocin release in lactating rats. Brain Res. 1988;457:303-9. PMID: 2851365
4. Radzyminski S. The effect of ultra low dose epidural analgesia on newborn breastfeeding behaviors. J Obstet Gynecol Neonatal Nurs. 2003;32:322-31. PMID: 12774874
5. Chang ZM, Heaman MI. Epidural analgesia during labor and delivery: effects on the initiation and continuation of effective breastfeeding. J Hum Lact. 2005;21:305-14. PMID: 16113019
6. Tharwat AA, Yehia AH, Wahba KA et al. Efficacy and safety of post-cesarean section incisional infiltration with lidocaine and epinephrine versus lidocaine alone in reducing postoperative pain: A randomized controlled double-blinded clinical trial. J Turk Ger Gynecol Assoc. 2016;17:1-5. PMID: 27026771
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