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Subsys and Breastfeeding

The active ingredient in Subsys (fentanyl sublingual spray) does pass through breast milk. Although some healthcare professionals generally consider Subsys to be compatible with breastfeeding, the manufacturer of the drug typically recommends that breastfeeding women avoid the medication. It may cause problems, such as breathing difficulty, tremors, or difficulty feeding, in a nursing infant.

Can Breastfeeding Women Use Subsys?

Subsys® (fentanyl sublingual spray) is a 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 Subsys while breastfeeding.
 
If you are breastfeeding or planning to start, talk to your healthcare provider before using Subsys.
 

More Information on Subsys and Breastfeeding

Exposing an infant to this medication through breast milk could lead to serious problems, such as:
 
  • Drowsiness
  • Difficulty feeding, which could lead to problems gaining weight
  • Breathing difficulty.
 
In addition, the infant may experience opioid withdrawal symptoms when breastfeeding is stopped. Some of the symptoms of withdrawal could include but are not limited to:
 
  • High-pitched crying
  • Irritability
  • Shakiness (tremors)
  • Difficulty feeding.
 
While the manufacturer recommends that Subsys not be used in women who are nursing, some experts (such as the American Academy of Pediatrics) generally consider fentanyl (the drug's active ingredient) compatible with breastfeeding, which means it is probably safe.
 
If your healthcare provider recommends Subsys 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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Subsys Medication Information

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