Ondansetron Safety During Breastfeeding
Yes, ondansetron is safe to use while breastfeeding. 1
Evidence-Based Recommendation
The Association of Anaesthetists 2020 guideline explicitly lists ondansetron among anti-emetic medications that are compatible with breastfeeding, categorizing it alongside other safe peri-operative drugs. 1 While the guideline acknowledges that there are no human studies on transfer into breast milk (only animal data), ondansetron is included in their table of drugs safe for use in breastfeeding women without any special precautions or waiting periods. 1
Key Clinical Points
Transfer to Breast Milk
- No human data exists on ondansetron transfer into breast milk, though animal studies provide some information. 1
- The lack of human studies does not preclude its use, as the guideline explicitly endorses its safety based on pharmacokinetic principles and clinical experience. 1
Practical Application
- No waiting period is required before resuming breastfeeding after ondansetron administration. 1
- Ondansetron can be used for both acute management (such as in food protein-induced enterocolitis syndrome) and peri-operative nausea/vomiting in breastfeeding women. 1
- The medication is listed alongside other commonly used anti-emetics (granisetron, cyclizine, prochlorperazine, dexamethasone, metoclopramide, domperidone) that are all considered compatible with breastfeeding. 1
Important Caveats
Cardiac Considerations
- Special caution is warranted in patients with underlying heart disease due to potential QT interval prolongation, though this is a general precaution not specific to breastfeeding. 1
- This cardiac risk applies to the mother's safety rather than infant exposure through breast milk. 1