Skip to Content

Hydrocodone use while Breastfeeding

Drugs containing Hydrocodone: Norco, Vicodin, Lortab, Hycodan, Hysingla ER, Hydromet, Tussionex Pennkinetic, Lorcet, Vicoprofen, Vicodin ES, Show all 351 »Zohydro ER, Hycet, Narcof, Hycomine, Hydrocodone CP, Vortex, Vicodin HP, Phenylephrine HD, Anexsia, Monte-G HC, TussiCaps, Hydrocodone HD, Vi-Q-Tuss, Codamine, Vituz, Coughtuss, Cyndal HD, Ventuss Syrup, Relasin-HC, Lortab ASA, Extendryl HC, Hydrocodone PA Pediatric, Hycomine Compound, Stagesic, Co-Gesic, Duocet, Zydone, Lorcet Plus, Panacet, Dolacet, Xodol, Protuss-D, Duratuss HD, Crantex HC, Uni-Lev 5.0, Tussafed-HCG, Dynatuss HC, De-Chlor G, Tussafed-HC, Hydro GP, Levall 5.0, Ambi 5/15/100, Atuss G, Mintuss G, S-T Forte, Flowtuss, Simuc-HD, Guiaplex HC, Gentex HC, Entuss-D JR, Tussgen Expectorant, Detussin Expectorant, Tussend Expectorant, Tussadur-HD, Vanex Expectorant, Decotuss-HD, HydroFed, Donatussin DC, Nazarin HC, MonteFlu HC, Nariz HC, Qual-Tussin DC, Exetuss-HC, A-Cof DH, Relasin-HCX, Condasin, Tussicle, Co-Tuss V Expectorant, Hycoclar Tuss, G-Tuss, Vicotuss, Hycosin Expectorant, Endacof XP, Vicoclear, Fentuss Expectorant, Vitussin Expectorant, Codotuss, Co-Tussin, Kwelcof, Propatuss Expectorant, Pneumotussin HC, Hycotuss Expectorant, Cotuss V, Hydrotuss, Z-Cof HCX, Pancof XP, Canges-XP, Nalex Expectorant, Hydro-Tussin HG, Atuss HX, Xpect-HC, Touro HC, Execof, Gua HC, Tusso-DF, Pneumotussin, Entuss, Pneumotussin 2.5, Medcodin, Hydrocod-GF, Hycoclear, SRC Expectorant, Poly-Tussin XP, Deconamine CX, Hydrophene DH, Poly Hist HC, Tussplex, Trimal DH, Mintuss MR, De-Chlor MR, Codituss DH, Codal-DH Syrup, Tussafin, Hyco-DH, Dicomal-DH, Hycomal DH, P-V-Tussin, Hytussin, Iotussin D Liquid, PhendaCof Plus, Tussgen, Rezira, Nalex-DH, Atuss EX, Procof D, Hydron KGS, KGS-HC, Hy-KXP, De-Chlor NX, Hydron EX, Procof, Entuss Expectorant, Codamine Pediatric, Marcof Expectorant, Protuss, Prolex DH, Hypamine, Hycophen Pediatric, Hycophen, Hycomine Pediatric, Lortuss HC, Tusdec-HC, Mintuss NX, Hytussin Expectorant, Hycofenix, Pseudatex HC, Entex HC, Dynex HD, Hydro-Tuss XP, Drituss HD, Tussafin Liquid, Tussigon, Su-Tuss HD Elixir, Vanacon, Spantuss HD, Medtuss HD, KG-Tuss HD, Hydrotussin HD, Entuss-D, Execlear, Hydrotropine, Histinex D, Ru-Tuss with Hydrocodone, Entuss-D Liquid, H-C Tussive D, ColdCough HCM, Pancof HC, SymTan, Liquituss HD, Vetuss HC Syrup, Rolatuss with Hydrocodone, Hydromide, Reprexain, Ibudone, Xylon 10, Detussin, Vantrela ER, Histussin D, Hydropane, Vicodin Tuss, Rindal HPD, Tusso-HC, Hydrocodone GF, Rindal-HD, Iodal HD, Chemdal HD, Endagen-HD, Novasus, HyTan, S-T Forte 2, Z-Tuss 2, Efasin-HD, Mintex HC, Histex HC, Tri-Vent HC, Max HC, Excof-SF, Donatussin MAX, Excof, Ed-TLC, Guiaphen HD, SymTan A, KG-Dal HD, Comtussin HC, Enplus-HD, Endal-HD Plus, Exo-Tuss, Chemtussin HC, Ditussin-HC, Endotuss-HD, Tuss-PD, Mintuss MS, Hyphen-HD, Ed-Tuss HC, Chlorgest HD, Iotussin HC, Nasatuss, Chemdal HD Plus, Vanex-HD, J-Tan D HC, Brovex HC, Maxi-Tuss SA, Maxidone, Theracodophen Low 90, Zamicet, Zolvit, Zyfrel, Hydrocet, Dolagesic, Vanacet, Hy-Phen, Liquicet, Lorcet 10/650, Lorcet HD, T-Gesic, Margesic H, Hydrogesic, Duradyne DHC, Verdrocet, Anolor DH5, Azdone, Endacof HC, Canges-HC, Bromcomp HC, Visvex, Bromph HD, Bromplex HD, Anaplex HD, Drocon-CS, M-END, VazoTuss HC, Alor 5/500, FluTuss HC, Canges-HC NR, BPM PE HC, VasoTuss HC, Tusnel-HC, Damason-P, Panasal 5/500, Tuss-HC, Maxi-Tuss HC, Ztuss ZT, A-G Tussin, Cordron-HC NR, Cordron-HC, Hydrocof-HC, Hydron PCS, Hydrotuss HC, P-V-Tussin Syrup, KG-Tussin, Q-V Tussin, Atuss HS, Tussin-V, Hyphed, Hexatussin, Welltuss HC, Tussend, Pediatex HC, JayCof-HC, Atuss HD, Cytuss-HC NR, Detuss, Tussinate, EndaCof-Tab, Maxi-Tuss HCG, CodiCLEAR DH, Obredon, D-Tann HC, Dytan-HC, Gestuss-HC, Endal HD, H-C Tussive-NR, Hydro-DP, Hydex PD, EndaCof-Plus, Notuss PD, Codimal DH, Zotex HC, Histussin HC Syrup, Histinex PV, Notuss, Histinex HC, Quindal HD Plus, B-Tuss, Tussive HC, Liquitussin HC Syrup, Duradal HD, Chlorphen HD, Hi-Tuss HC, Quindal HD, Efasin-HD Plus, Hydron CP, Tuss-DS, Cytuss HC, Histussin HC Liquid, H-C Tussive, Uni Tuss HC, Highland HC, KG-Dal HD Plus, Hydro-PC II, De-Chlor HD, Notuss-Forte, Neo HC, Zutripro, Relacon-HC, Maxi-Tuss HCX, Z-Cof HC, DroTuss-CP, Liquicough HC, Poly-Tussin HD, Tusana-D, De-Chlor HC, Relacon-HC NR, Phendal-HD, Echotuss-HC, Rindal HD Plus, Uni-Tricof HC, Triant-HC, Hydro-PC II Plus, Atuss MS, Zymine HC

Medically reviewed by Last updated on Mar 23, 2020.

Hydrocodone Levels and Effects while Breastfeeding

Summary of Use during Lactation

Hydrocodone is a opioid narcotic. Benzhydrocodone is a hydrocodone prodrug that is rapidly converted into hydrocodone in the gastrointestinal tract. Maternal use of oral narcotics during breastfeeding can cause infant drowsiness, central nervous system depression and even death. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. Once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of oral hydrocodone to a few days at a maximum dosage of 30 mg daily with close infant monitoring. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately.

Drug Levels

Hydrocodone is metabolized to 6 active metabolites, including hydromorphone.

Maternal Levels. Two hospitalized mothers were taking hydrocodone and acetaminophen combination for pain and pumped their milk for their nonhospitalized infants. They donated samples of their pumped milk for analysis of hydrocodone. One mother had 17 milk hydrocodone levels measured over 4 days while taking first 10 mg and then 5 mg of hydrocodone bitartrate as needed, beginning on day 7 postpartum. Her milk hydrocodone levels ranged from 8.6 to 127.3 mcg/L. The second mother had 5 milk hydrocodone levels measured over 1.5 days while taking 5 mg doses of hydrocodone bitartrate. Her milk hydrocodone levels ranged from 5.2 to 47.2 mcg/L, beginning at day 16 postpartum. Their infants received an estimated 3.1 and 3.7% of the maternal weight-adjusted dosages, but the absolute hydrocodone dosages were 8.58 mcg/kg and 3.07 mcg/kg daily because of the differences in the dosages ingested by their mothers.[1]

A study of 30 postpartum women taking a hydrocodone-containing product for postpartum pain measured hydrocodone and hydromorphone in breastmilk. Milk samples were collected after lactogenesis II was judged to have occurred, usually starting on the third postpartum day. Mean and median maternal dosages of hydrocodone base were 175 and 145 mcg/kg daily, respectively (range 44.3 to 423.2 mcg/kg daily). The mean and median milk hydrocodone concentrations were 25.9 and 14.2 mcg/L, respectively. Only 12 of the 30 women had hydromorphone detectable (>1 mcg/L) in their milk with a median milk hydromorphone concentration of 1.9 mcg/L. Mean and median infant daily dosages of hydrocodone were 3.9 and 2.1 mcg/kg, respectively, which were equal to 2.4 and 1.6% of the weight-adjusted maternal dosage, respectively. Mean and median infant dosage of hydromorphone were 2.1 and 0.3 mcg/kg daily, respectively. Two women excreted much more hydromorphone into their milk than the others and might represent ultrarapid CYP2D6 metabolizers. Taking the two narcotics' potencies into account, a fully breastfed neonate would receive a mean and median of 1.5 and 0.7% of the minimum infant therapeutic opiate dosage; however, neonates might be more susceptible to the opiates than the older infants on whom these dosages were based. The authors concluded that maternal dosages of hydrocodone bitartrate up to 30 to 35 mg daily are unlikely to adversely affect breastfed neonates, but that prolonged use of dosages over 40 mg daily should be avoided during breastfeeding.[2]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

The 18-day-old infant of a breastfeeding mother became groggy and "slept for most of the day" while the mother was taking 20 mg of oral hydrocodone combined with 1300 mg of acetaminophen every 4 hours for painful nipple candidiasis and mastitis. The mother decreased her dose by one-half and the infant apparently no longer experienced grogginess or hypersomnolence.[3] The infant's symptoms were probably due to the maternal hydrocodone.

A 5-week-old breastfed infant became cyanotic and required mouth-to-mouth resuscitation and intubation. The infant's urine was positive for opioids and the infant responded positively to naloxone; the level of consciousness improved over 2 days and extubation was accomplished. The infant's mother admitted to taking a hydrocodone-acetaminophen combination product and methadone that had been prescribed for migraine headache before she was breastfeeding.[4] The infant's symptoms were probably due to the maternal opiate use.

Effects on Lactation and Breastmilk

Narcotics can increase serum prolactin.[5] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternate Drugs to Consider

Acetaminophen, Butorphanol, Hydromorphone, Ibuprofen, Morphine


1. Anderson PO, Sauberan J, Lane JR, Rossi SS. Hydrocodone excretion into breastmilk: the first two reported cases. Breastfeed Med 2007;2:10-4. PMID: 17661614

2. Sauberan JB, Anderson PO, Lane JR et al. Breast milk hydrocodone and hydromorphone levels in mothers using hydrocodone for postpartum pain. Obstet Gynecol. 2011;117:611-7. PMID: 21343764

3. Bodley V, Powers D. Long-term treatment of a breastfeeding mother with fluconazole-resolved nipple pain caused by yeast: a case study. J Hum Lact. 1997;13:307-11. PMID: 9429366

4. Meyer D, Tobias JD. Adverse effects following the inadvertent administration of opioids to infants and children. Clin Pediatr (Phila). 2005;44:499-503. PMID: 16015396

5. Tolis G, Dent R, Guyda H. Opiates, prolactin, and the dopamine receptor. J Clin Endocrinol Metab. 1978;47:200-3. PMID: 263291

Hydrocodone Identification

Substance Name


CAS Registry Number


Drug Class

Breast Feeding


Analgesics, Opioid


Antitussive Agents

Administrative Information

LactMed Record Number



Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.