Last update: April 23, 2021
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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A sympathomimetic drug and central nervous system stimulant, it has a similar action and uses to amphetamine, its dextro isomer.
It is used (GSK, 2007) in the treatment of narcolepsy (Wise, 2007) and Attention Deficit Hyperactivity Disorder (ADHD), and is also used as an illegal drug (Oei, 2012).
It is excreted in breast milk, concentrating about 3 times more than in plasma. This concentration assumes a relative dose about 6% (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 the development and health of infants (Oei, 2012, Wise, 2007; Moretti, 2000), but it is known that they are more exposed to social problems, domestic violence, and lower breastfeeding rates (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 (narcolepsy, ADHD) of dexamphetamine 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).
To minimize the risk, after the last recreational use of amphetamine, it is advisable to wait 55 hours (5 T ½, which eliminates 97% of the substance) before breastfeeding again. Meanwhile, express and discard milk from the breast regularly to maintain production.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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