Until a few days ago, Nolotil, a trademark of a drug whose active substance is metamizol, could be safely consumed during breastfeeding. But this analgesic especially used during postpartum (especially after caesarean section), has become considered "probable high risk", so its use is not recommended.
From the e-lactancia.org portal, they offer other safe alternatives for breastfeeding, such as ibuprofen or paracetamol. We tell you the reasons for this update in the recommendations.
The risk rises after the results of a study
The e-breastfeeding website, a reference for all nursing mothers who wish to check if a medication is safe or not during breastfeeding, just updated your recommendations about metamizol, active compound of Nolotil.
Until now, metamizol was classified as "low risk" to be consumed during breastfeeding, but after the results of a study, e-breastfeeding has decided to raise its level of risk, and does not recommend consuming it as considered "unsafe".
This is the warning we can read on their website:
"Authorized and widely used in childbirth and puerperium in several countries in Europe and America (Bordini 2016, Chaves 2009, Sabo 2001, DUP 1992); not so in the US and UK since the 1970s due to risk of rashes, anaphylaxis and agranulocytosis (< 2 per million) actually lower than other medications (Bordini 2016) "
In VitónicaNolotil and metamizol: the side effects in tourists may be due to a genetic issue"It is excreted in breast milk in a quantity that could be significant (Zylber 1986, Rizzoni 1984). It has been detected in plasma or in the urine of infants whose mothers took it (Rizzoni 1984). No side effects have been described in infants of mothers taking it. except for a cyanosis crisis (Rizzoni 1984) "
"An increased risk of acute lymphocytic leukemia has been found in children whose mothers took metamizole during pregnancy and lactation (Couto 2015) ".
"Until we know more published data on this drug in relation to breastfeeding, safer known alternatives are preferable (Bar-Oz 2003), especially during the neonatal period and in case of prematurity."
What does the study say?
The study referred to was published in 2015, and was carried out in Brazil.
The objective was to determine whether the use of analgesics during pregnancy and lactation could constitute a risk factor in the development of childhood leukemia. Thus, it was seen that the use of dipyrone (metamizol) "can act as a risk factor" in the development of leukemia at an early age.
In Babies and more Childhood leukemia: a new study suggests that in the future it could be preventedWhat do I do if I have taken Nolotil while breastfeeding?
Health professionals and lactation consultants insist on asking for calm, for the moment the results are inconclusive, and more studies are needed to confirm these data. But until then, it is preferable to measure the risk / benefit, and having safe alternatives it is advisable not to risk.
See this post on Instagram🤚🤚 IMPORTANT🤚🤚: The Nolotil that until now could be taken during breastfeeding with a low risk, has just changed categories and should NOT be used if we are breastfeeding. As an alternative for pain and / or fever you can use Ibuprofen or Paracetamol. 👉 If you have any doubts about whether or not you can have a drink, do not hesitate to consult e-lactancia.org for the best consultation page for both families and professionals. 100 percent reliable. Do not panic among those who have already taken it (myself in my two postparts), the recommendations have changed pending further studies. KEEP CALM ☺️ We continue !!! You have all the info 👉 //e-lactancia.org/breastfeeding/metamizole/product/ #luciamipediatra
A shared publication of Lucia my Pediatrician, writer. (@luciamipediatra) on Apr 6, 2019 at 6:48 PDT
See this post on Instagram"PREGNANT PREGNANCY and BREASTFEEDING". Metamizol, better known as Nolotil, has changed the degree of risk in e-lactancia.org and should no longer be taken in pregnancy or breastfeeding ... In 2015 a study was published (//www.ncbi.nlm.nih .gov / pubmed / 25121973) in which it was found that:. "An increased risk of acute lymphocytic leukemia has been found in children whose mothers took metamizole during pregnancy and lactation (Couto 2015)." . This means that there is more risk, not that it will happen. Think that if the risk were exaggerated this would be known for a longer time, because many women have taken Nolotil both in pregnancy and breastfeeding. Now we know that added risk and warns not to run it unnecessarily ... Send it to all those who are waiting for a baby and who are breastfeeding ... Paracetamol and Ibuprofen are offered as alternatives in breastfeeding, and as Diclofenac as an anti-inflammatory ( Voltaren), which are all considered safe ... PS: If the risk were high today there would be THOUSANDS of children with leukemia for this reason. But is not the case. It is a somewhat greater risk than if it is not consumed, so being a low risk it is considered appropriate to avoid it, especially because there are safer alternatives ... #Lactation #Pregnancy #Medicaments # Update #Security #Nolotil #LactanciaMaterna #RisgosDeSalud
A shared post by Armando Bastida (@armandobastidaep) on Apr 7, 2019 at 1:10 PDT
We have asked Carmen Vega, international lactation consultant (IBCLC) and family doctor, to explain to us what exactly this recommendation means and what happens if we have been consuming Nolotil while we were breastfeeding our baby:
"In e-breastfeeding they have changed the level of risk as a precaution, but not because it has been shown that metamizol is related to childhood leukemia," Carmen clarifies."The study in question It is a single case-control study. Although these types of studies are well designed, they have a very low level of evidence and serve to open possible lines of investigation, but show, show little. "
"It's about a isolated study with a low level of evidence which suggests that it might be possible that perhaps this relationship exists. So for a precautionary principle it is better to avoid it. But if at any given time it is necessary, you must assess the risk / benefit balance and then decide with your doctor. "
What safe alternatives exist?
Metamizole is a non-steroidal analgesic and anti-inflammatory, used to relieve pain and lower fever. In hospitals it is usually injected intravenously after giving birth, especially if you have had a C-section, or given orally.
As this news is recent and Nolotil has been using and recommending time, there are likely to be health professionals who are not yet informed. Therefore, it is important that nursing mothers know this update and know that the ibuprofen and paracetamol are the recommended safe alternatives.
