코데인(Dihydrocodeine bitartrate)

 약물의 분류: 마약성진통제

 임신부 약물등급(US FDA): C

임신부 안전 및 기형발생정보 :Dihydrocodeine (Drocode) is an opioid used as an analgesic and antitussive. We have not located references on early pregnancy effects of this agent; however, information on codeine might be relevant.Use of dihydrocodeine for analgesia during labor has been associated with neonatal respiratory depression. This property is shared by other opioid analgesics.

 모유수유부 약물등급(Medication and Mother’s MilK): 정보없음

모유수유 안전 및 유해성정보 :According to the product labeling for a capsule containing aspirin, caffeine, and dihydrocodeine bitartrate, dihydrocodeine bitartrate is excreted into human milk. In mothers with normal activity of the CYP2D6 enzyme that metabolizes the drug, the amount of dihydrocodeine in milk is dose-dependent and low. When the CYP2D6 enzyme of the mother is a variant that produces ultra-rapid metabolism of the agent, higher than expected and potentially dangerous concentrations of the metabolite dihydromorphine can be present in milk. A case report described in an abstract a nursing infant with presumed sedation from exposure to this agent in milk. The infant`s symptoms resolved within 24 hours after drug exposure was eliminated.

 한국마더세이프전문상담센터 DB 정보 (모태독성학2016):

1) 기형발생정보
코데인에 노출된 후 추적된 임신부는 총 547례이었으며 초기 노출 후 자연유산율은 6.4%(35/547) 이었다. 임신 37주 이전의 조산률은 3.6%(18/494), 2,500 g 미만의 저체중증은 2.4%(12/492)이었
다. 주요기형발생은 2.6%(13/492): PDA(2), cyst in caudothalamic groove(1), dysplastic kidney left with megaureter(1), nasolacrimal duct obstruction with ptosis(1), hydronephrosis(2), MCDK(1), right liver mass(1), ASD with small PDA(1), right inguinal hernia(1), cleft palate(1), undefined major anomaly(1)가 있었다. 그리고 사산 2례가 있었다.

2) 모유 수유 시 독성 및 적합성 정보
수유부-수유아 12 쌍 중 부작용 사례는 없었다.