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Exalgo and Breastfeeding

According to the manufacturer of Exalgo (hydromorphone ER), women should avoid using this medication while breastfeeding. Research studies have shown that the active ingredient passes through breast milk and may cause potentially serious problems in the infant, such as poor feeding or difficulty breathing. Before using Exalgo, breastfeeding women should ask their healthcare providers about the potential risks.

Can Breastfeeding Women Take Exalgo?

Exalgo™ (hydromorphone ER) passes through breast milk. The manufacturer does not recommend that women use this medication while breastfeeding. If you are nursing a child, talk with your healthcare provider before taking Exalgo.

What Does the Research Say About Exalgo and Breastfeeding?

Hydromorphone (the active ingredient in Exalgo) passes through breast milk in low amounts. If the nursing infant is exposed to a significant amount of hydromorphone, potentially serious problems could occur, such as drowsiness, poor feeding (due to drowsiness or stomach upset), constipation, or even difficulty breathing.
In addition, a breastfed infant could experience withdrawal symptoms when hydromorphone is stopped (see Exalgo Withdrawal).
It is important to note that Exalgo is not appropriate for most breastfeeding mothers. This pain medication is approved only for long-term, around-the-clock use to treat long-lasting pain. It should not be used for short-term pain, such as most pain related to childbirth. In addition, Exalgo is appropriate only for people who are accustomed to taking regular, significant doses of opioids.
Because this medication provides an extended release of hydromorphone, it is likely that a breastfed infant would be exposed to a larger dose of hydromorphone compared to short-acting hydromorphone products.
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