From the Guidelines
Voltaren (diclofenac) is considered safe to use during breastfeeding, as only small amounts are detected in breast milk and it has been used extensively during lactation without adverse effects. According to the guideline on anaesthesia and sedation in breastfeeding women 2020 from the Association of Anaesthetists 1, diclofenac is one of the NSAIDs that can be used by breastfeeding mothers. The key points to consider when using Voltaren while breastfeeding include:
- Using the lowest effective dose for the shortest duration possible
- Considering topical formulations (gels or patches) as safer options due to minimal systemic absorption
- Being cautious if the infant is premature or has kidney problems
- Informing the healthcare provider about breastfeeding before starting the medication to discuss optimal timing of doses in relation to feeding sessions. The safety of diclofenac during breastfeeding is supported by its widespread use and the low levels detected in breast milk, making it a viable option for managing pain in nursing mothers 1.
From the FDA Drug Label
Risk Summary Based on available data, diclofenac may be present in human milk The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for diclofenac potassium tablets and any potential adverse effects on the breastfed infant from the diclofenac potassium tablets or from the underlying maternal condition Data One woman treated orally with a diclofenac salt, 150 mg/day, had a milk diclofenac level of 100 mcg/L, equivalent to an infant dose of about 0. 03 mg/kg/day. Diclofenac was not detectable in breast milk in 12 women using diclofenac (after either 100 mg/day orally for 7 days or a single 50 mg intramuscular dose administered in the immediate postpartum period).
Voltran (diclofenac) safety in breastfeeding is uncertain due to limited data.
- The drug may be present in human milk, with one study showing a milk diclofenac level of 100 mcg/L, equivalent to an infant dose of about 0.03 mg/kg/day.
- However, diclofenac was not detectable in breast milk in 12 women using the drug.
- The decision to use diclofenac potassium tablets during breastfeeding should consider the mother's clinical need and potential adverse effects on the breastfed infant 2.
From the Research
Voltran Safety in Breastfeeding
- There are no direct studies on the safety of Voltran in breastfeeding.
- However, the provided studies discuss the safety of various medications during breastfeeding, including antiepileptic drugs 3, direct oral anticoagulants 4, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac 5, 6.
- The study on antiepileptic drugs during breastfeeding suggests that some medications, such as phenobarbital, primidone, and carbamazepine, are probably compatible with breastfeeding, while others may require careful monitoring of the infant for side effects 3.
- The study on direct oral anticoagulants during breastfeeding found that dabigatran has the least excretion in human breast milk, while apixaban has a higher milk excretion 4.
- The studies on diclofenac discuss its pharmacology, pharmacokinetics, and clinical efficacy, but do not specifically address its safety during breastfeeding 5, 6.
- The study on which drugs are contraindicated during breastfeeding mentions that only a few drugs pose a clinically significant risk to breastfed babies, including antineoplastics, drugs of abuse, and some anticonvulsants, but does not mention Voltran or similar medications 7.