I am new to this group, and am merely a lactating pharmacist taking the
very first steps towards my IBCLC. 

This Tylenol #3 incident has me very interested. Tylenol #3 is a part of
our standard post-partum orders at my hospital, along with Percocet and
Lortab. I find that Tylenol #3 is not as effective as Percocet and
Lortab for pain relief, and is associated with a much higher rate of
adverse effects (nausea and vomiting, especially). Since we have more
effective opiate options for pain that are not metabolized to morphine,
I think that we should abandon routine use of Tylenol #3 in all new
mothers, and reserve its use for special requests (which I'd imagine
we'll never get). 

If we don't abandon the use of this drug routinely in post-partum cases,
we need to have a check-box on the post-partum orders to inform pharmacy
which patients are breast feeding and which are not, so that pharmacists
can suggest selection of other pain medications for nursing moms. This
is completely avoidable. 

Sincerely, 
Laura Block, PharmD
Snellville, GA 

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