The Basics
What is Amphetamine?
Powerful stimulator of the central nervous system used to treat narcolepsy and ADHD.
Brand names for Amphetamine
Dyanavel Xr, Evekeo
How Amphetamine is classified
Adrenergic Agents, Central Nervous System Stimulants, Dopamine Agents, Sympathomimetics
Amphetamine During Pregnancy
Amphetamine pregnancy category
Category Note that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Amphetamine while pregnant
N/A
Taking Amphetamine While Breastfeeding
What are recommendations for lactation if you're taking Amphetamine?
In dosages prescribed for medical indications, some evidence indicates that amphetamine does not affect nursing infants adversely. The effect of amphetamine in milk on the neurological development of the infant has not been well studied. Large dosages of amphetamine might interfere with milk production, especially in women whose lactation is not well established. Breastfeeding is generally discouraged in mothers who are actively abusing amphetamines.[1][2][3] One expert recommends that amphetamine not be used therapeutically in nursing mothers.[4]
Maternal / infant drug levels
In dosages prescribed for medical indications, some evidence indicates that amphetamine does not affect nursing infants adversely. The effect of amphetamine in milk on the neurological development of the infant has not been well studied. Large dosages of amphetamine might interfere with milk production, especially in women whose lactation is not well established. Breastfeeding is generally discouraged in mothers who are actively abusing amphetamines.[1][2][3] One expert recommends that amphetamine not be used therapeutically in nursing mothers.[4]
Possible effects of Amphetamine on milk supply
In 2 papers by the same authors, 20 women with normal physiologic hyperprolactinemia were studied on days 2 or 3 postpartum. Eight received dextroamphetamine 7.5 mg intravenously, 6 received 15 mg intravenously and 6 who served as controls received intravenous saline. The 7.5 mg dose reduced serum prolactin by 25 to 32% compared to control, but the difference was not statistically significant. The 15 mg dose significantly decreased serum prolactin by 30 to 37% at times after the infusion. No assessment of milk production was presented.[7][8] The authors also quoted data from another study showing that a 20 mg oral dose of dextroamphetamine produced a sustained suppression of serum prolactin by 40% in postpartum women. The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.
In a retrospective Australian study, mothers who used intravenous amphetamines during pregnancy were less likely to be breastfeeding their newborn infants at discharge than mothers who abused other drugs (27% vs 42%). The cause of this difference was not determined.[9]
A mother took amphetamine 35 mg daily for narcolepsy during pregnancy and postpartum. She exclusively breastfed her infant for 6 months with no evidence of an adverse effect on milk production.[6]
Possible alternatives to Amphetamine
(Therapeutic use) Dextroamphetamine, Lisdexamfetamine, Methylphenidate.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Oei JL, Kingsbury A, Dhawan A et al. Amphetamines, the pregnant woman and her children: A review. J Perinatol. 2012;32:737-47. PMID: 22652562
2. AAP Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827-41. PMID: 22371471
3. Wong S, Ordean A, Kahan M. SOGC clinical practice guidelines: Substance use in pregnancy: No. 256, April 2011. Int J Gynaecol Obstet. 2011;114:190-202. PMID: 21870360
4. Ornoy A. Pharmacological treatment of attention deficit hyperactivity disorder during pregnancy and lactation. Pharm Res. 2018;35:46. PMID: 29411149
5. Steiner E, Villen T, Hallberg M et al. Amphetamine secretion in breast milk. Eur J Clin Pharmacol. 1984;27(1):123-4. PMID: 6489423
6. Ohman I, Wikner BN, Beck O, Sarman I. Narcolepsy treated with racemic amphetamine during pregnancy and breastfeeding. J Hum Lact. 2015;31:374-6. PMID: 25948577
7. DeLeo V, Cella SG, Camanni F et al. Prolactin lowering effect of amphetamine in normoprolactinemic subjects and in physiological and pathological hyperprolactinemia. Horm Metab Res. 1983;15:439-43. PMID: 6642414
8. Petraglia F, De Leo V, Sardelli S et al. Prolactin changes after administration of agonist and antagonist dopaminergic drugs in puerperal women. Gynecol Obstet Invest. 1987;23:103-9. PMID: 3583091
9. Oei JL, Abdel-Latif ME, Clark R et al. Short-term outcomes of mothers and infants exposed to antenatal amphetamines. Arch Dis Child Fetal Neonatal Ed. 2010;95:F36-F41. PMID: 19679891
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.