Last update: Sept. 2, 2017

(2S)-2,6-Diamino-N-[(1S)-1-methyl-2-phenylethyl]hexanamide dimethanesulfonate

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

A prodrug that is metabolized directly in the intestine to dextroamphetamine. It is used to treat Attention Deficit Hyperactivity Disorder (ADHD) and bulimia.

Dextroamfetamine is a sympathomimetic drug, central nervous system stimulant, whose action and uses are similar to amphetamine (see information) which is its dextro isomer.

It is excreted in breast milk, concentrating about 3 times more than in plasma and resulting in a relative dose of around 6% for the infant (Ilett, 2007).
In infants whose mothers were taking dexamfetamine as treatment for ADHD, levels ranging from undetectable to 14% of maternal plasma levels have been measured and no problems were observed in the clinical follow-up of these infants (Ilett, 2007).

There is little information on the impact of amphetamine abuse on infant development and health (Oei, 2012, Wise, 2007; Moretti, 2000), but it is known that they are more exposed to social problems, domestic violence, and lower rates of breastfeeding (Oei, 2010).

There is controversy over the possibly mild negative effect of amphetamine on prolactin (Petraglia, 1987; DeLeo, 1983), but milk production in mothers who took it therapeutically was not affected (Öhman, 2015).

During breastfeeding, the therapeutic use (ADHD, bulimia) of amphetamine can be assessed, using the lowest possible effective dose and monitoring the occurrence of irritability, insomnia, lack of appetite and weight loss.

Its use as an illegal drug is totally discouraged (Oei, 2012).


See below the information of this related product:

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

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Other names

(2S)-2,6-Diamino-N-[(1S)-1-methyl-2-phenylethyl]hexanamide dimethanesulfonate is Lisdexamfetamine Mesilate in Chemical name.

Is written in other languages:

(2S)-2,6-Diamino-N-[(1S)-1-methyl-2-phenylethyl]hexanamide dimethanesulfonate is also known as

Group

(2S)-2,6-Diamino-N-[(1S)-1-methyl-2-phenylethyl]hexanamide dimethanesulfonate belongs to this group or family:

Tradenames

Main tradenames from several countries containing (2S)-2,6-Diamino-N-[(1S)-1-methyl-2-phenylethyl]hexanamide dimethanesulfonate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 96 %
Molecular weight 456 daltons
Protein Binding 16 - 20 %
VD 3,2 - 5,6 l/Kg
Tmax 3,5 - 4,7 hours
T1/2 6,8 - 11 hours
M/P ratio 3,3 (2,2 - 4,8) -
Theoretical Dose 5,7 (4 - 10,6) mg/Kg/d

References

  1. AEMPS. Lisdexanfetamina. Ficha técnica. 2016 Full text (in our servers)
  2. Öhman I, Wikner BN, Beck O, Sarman I. Narcolepsy Treated with Racemic Amphetamine during Pregnancy and Breastfeeding. J Hum Lact. 2015 Abstract
  3. Shire. Lisdexamfetamine. Drug Summary. 2013 Full text (in our servers)
  4. Oei JL, Kingsbury A, Dhawan A, Burns L, Feller JM, Clews S, Falconer J, Abdel-Latif ME. Amphetamines, the pregnant woman and her children: a review. J Perinatol. 2012 Abstract Full text (link to original source) Full text (in our servers)
  5. Oei J, Abdel-Latif ME, Clark R, Craig F, Lui K. Short-term outcomes of mothers and infants exposed to antenatal amphetamines. Arch Dis Child Fetal Neonatal Ed. 2010 Abstract
  6. Wise MS, Arand DL, Auger RR, Brooks SN, Watson NF; American Academy of Sleep Medicine. Treatment of narcolepsy and other hypersomnias of central origin. Sleep. 2007 Abstract Full text (link to original source) Full text (in our servers)
  7. Ilett KF, Hackett LP, Kristensen JH, Kohan R. Transfer of dexamphetamine into breast milk during treatment for attention deficit hyperactivity disorder. Br J Clin Pharmacol. 2007 Abstract
  8. Moretti ME, Lee A, Ito S. Which drugs are contraindicated during breastfeeding? Practice guidelines. Can Fam Physician. 2000 Sep;46:1753-7. Review. Abstract Full text (link to original source) Full text (in our servers)
  9. Petraglia F, De Leo V, Sardelli S, Mazzullo G, Gioffrè WR, Genazzani AR, D'Antona N. Prolactin changes after administration of agonist and antagonist dopaminergic drugs in puerperal women. Gynecol Obstet Invest. 1987;23(2):103-9. Abstract
  10. DeLeo V, Cella SG, Camanni F, Genazzani AR, Müller EE. Prolactin lowering effect of amphetamine in normoprolactinemic subjects and in physiological and pathological hyperprolactinemia. Horm Metab Res. 1983 Abstract

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