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Abstral and Breastfeeding

Research has shown that the active ingredient in Abstral (fentanyl sublingual tablets) passes through breast milk. Although the American Academy of Pediatrics generally considers Abstral to be compatible with breastfeeding, the manufacturers of the drug typically recommend that breastfeeding women avoid the medication. It may cause problems, such as irritability and difficulty feeding, in a nursing infant.

Is Abstral Safe to Take While Breastfeeding?

Abstral® (fentanyl sublingual tablets) is prescription pain medication licensed to manage breakthrough pain in people with cancer who are already taking regularly scheduled opioid narcotic pain medication for their constant pain. This medication is known to pass through breast milk. The manufacturer recommends that women avoid Abstral while breastfeeding.
If you are breastfeeding or thinking about breastfeeding, you should talk to your healthcare provider before using Abstral.

More Information on Breastfeeding and Abstral

Fentanyl, the active ingredient of Abstral, passes through breast milk. While the amount of fentanyl passed through breast milk is thought to be small, most studies have looked at single fentanyl doses. There is very little information available about the effects of repeated fentanyl doses, which would be the case with Abstral use.
Exposing an infant to this medication may lead to serious problems, including drowsiness, difficulty feeding (which could cause problems gaining weight), or breathing problems. In addition, the infant may experience opioid withdrawal symptoms when breastfeeding is stopped. Such symptoms of withdrawal could include but are not limited to:
  • High-pitched crying
  • Irritability
  • Shakiness (tremors)
  • Difficulty feeding.
While the manufacturer recommends that Abstral not be used in women who are nursing, some experts (such as the American Academy of Pediatrics) generally consider fentanyl compatible with breastfeeding, which means it is probably safe.
If your healthcare provider recommends Abstral while breastfeeding, make sure to watch for any problems in your infant, such as:
  • Breathing problems, including slow and shallow breaths
  • Difficulty feeding
  • Extreme sleepiness.
If you notice any of these problems, or if something "just does not seem right," immediately contact your healthcare provider.
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Abstral Medication Information

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