Narcotic Agonist Analgesic
PREGNANCY RECOMMENDATION: Human Data Suggest Risk in 3rd Trimester
BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible
PREGNANCY SUMMARY
No reports linking the use of dihydrocodeine with congenital defects have been located. Usage in pregnancy is primarily confined to labor. Respiratory depression in the newborn has been reported to be less than that with meperidine, but depression is probably similar when equianalgesic doses are compared (1–4). If dihydrocodeine is used in pregnancy, healthcare professionals are encouraged to call the toll-free number (800-670-6126) for information about patient enrollment in the Motherisk study.
BREASTFEEDING SUMMARY
No reports describing the use of dihydrocodeine bitartrate during lactation have been located. Because other opiates are excreted into milk (e.g., see Morphine) and the molecular weight (about 452) of dihydrocodeine bitartrate is low enough, the presence of the narcotic in milk should be expected. The long-term effects on neurobehavior and development in a nursing infant are unknown but warrant study.
References
1.Sliom CM. Analgesia during labour: a comparison between dihydrocodeine and pethidine. S Afr Med J 1970;44:317–9.
2.Ruch WA, Ruch RM. A preliminary report on dihydrocodeine-scopolamine in obstetrics. Am J Obstet Gynecol 1957;74:1125–7.
3.Myers JD. A preliminary clinical evaluation of dihydrocodeine bitartrate in normal parturition. Am J Obstet Gynecol 1958;75:1096–100.
4.Bonica JJ. Principles and Practice of Obstetric Analgesia and Anaesthesia. Philadelphia, PA: FA Davis, 1967:245.