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Journal of Human Lactation, Vol. 20, No. 3, 322-326 (2004)
DOI: 10.1177/0890334404266881
© 2004 International Lactation Consultant Association

Transfer of Naltrexone and its Metabolite 6, B-Naltrexol into Human Milk

Carol F. Chan, BSc

Pharmacology Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia.

Madhu Page-Sharp, PhD

Pharmacology Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia.

Judith H. Kristensen, BPharm

Pharmacy Department, King Edward Memorial Hospital for Women, Subiaco, Western Australia

George O’Neil, MB, BS, MRCOG

Australian Medical Procedures Research Foundation, Subiaco, Western Australia

Kenneth F. Ilett, BPharm, PhD

the Pharmacology Unit, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, and Clinical Pharmacology & Toxicology, Western Australian Centre for Pathology & Medical Research, Nedlands Western Australia

The excretion of naltrexone and its primary metabolite 6,B-naltrexol in breast milk from a 30-year-old lactating opiate addict undergoing oral naltrexone pharmacotherapy (5 mg/d) was studied. Concentrations of naltrexone and 6,B-naltrexol in serial milk and plasma samples taken over a 19.3-hour period of a dose interval at steady state were measured by gas chromatography. The calculated infant dose relative to the maternal weight was 0.03% for naltrexone and 0.83% (as naltrexone equivalents) for 6,B-naltrexol. Total relative infant dose estimated for the complete 24-hour dose intervalwas 1.06%. Her 6-week-old breastfed infant was healthy, achieving expected milestones, and showed no adverse effects. Only 6,B-naltrexol was detected in infant plasma and at a very low concentration of 1.1 µ g/L. Use of naltrexone during breastfeeding should be undertaken only after an individual riskbenefit analysis. J Hum Lact. 20(3):322-326.

Key Words: naltrexone • human milk • infant dose


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