Last update: May 16, 2019

Amfepramone Hydrochloride

Very High Risk for breastfeeding


Very unsafe. Contraindicated.
Use of an alternative or cessation of breastfeeding.

A centrally-acting and indirect sympathomimetic appetite suppressant similar to dexamfetamine which can create dependency (WHO 2003).
It has been used in the treatment of obese people.
It produces insomnia, anorexia, nervousness and major side effects, especially cardiac effects (Cheung 2013). There have been reports of psychosis and hallucinations and a case of ketoacidosis in a woman affected by diabetes (Branis 2015).

Although there is no published data on its effects on breastfed infants, according to the manufacturer it is excreted in breastmilk, meaning its use during breastfeeding is not recommended (UDS 2011).

The lack of published pharmacological data makes it difficult to accurately predict its possible excretion in breastmilk.

Until there is more published data on this drug in relation to breastfeeding, safer known alternatives are preferable, especially during the neonatal period and in case of prematurity.

There is a risk it may become a drug of abuse (WHO 2003) and was withdrawn from sale in the European Union in 2000 (AEMPS 2000).

None of the current pharmacological treatments for obesity is safe for use in pregnant or breastfeeding women (Rodríguez 2016).

There is good quality evidence that exclusive breastfeeding helps to regain pre-pregnancy weight earlier than if breastfeeding is partial (mixed) or there is no breastfeeding, and that prolonged breastfeeding helps maintain that loss and as well as body fat loss (Schalla 2017, López 2016, Neville 2014, Sámano 2013, Hatsu 2008, Dewey 2004, 2001 and 1993, Kramer 1993).

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.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Group

Amfepramone Hydrochloride belongs to this group or family:

Tradenames

Main tradenames from several countries containing Amfepramone Hydrochloride in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 70 %
Molecular weight 242 daltons
Protein Binding 70 %
pKa 7,44 -
Tmax 2 hours
T1/2 4 - 8 hours

References

  1. Schalla SC, Witcomb GL, Haycraft E. Body Shape and Weight Loss as Motivators for Breastfeeding Initiation and Continuation. Int J Environ Res Public Health. 2017 Jul 11;14(7). pii: E754. Abstract
  2. López-Olmedo N, Hernández-Cordero S, Neufeld LM, García-Guerra A, Mejía-Rodríguez F, Méndez Gómez-Humarán I. The Associations of Maternal Weight Change with Breastfeeding, Diet and Physical Activity During the Postpartum Period. Matern Child Health J. 2016 Feb;20(2):270-80. Abstract
  3. Rodríguez JE, Campbell KM. Past, Present, and Future of Pharmacologic Therapy in Obesity. Prim Care. 2016 Mar;43(1):61-7, viii. Abstract
  4. Branis NM, Wittlin SD. Amphetamine-Like Analogues in Diabetes: Speeding towards Ketogenesis. Case Rep Endocrinol. 2015;2015:917869. Abstract
  5. Neville CE, McKinley MC, Holmes VA, Spence D, Woodside JV. The relationship between breastfeeding and postpartum weight change--a systematic review and critical evaluation. Int J Obes (Lond). 2014 Apr;38(4):577-90. Abstract
  6. Sámano R, Martínez-Rojano H, Godínez Martínez E, Sánchez Jiménez B, Villeda Rodríguez GP, Pérez Zamora J, Casanueva E. Effects of breastfeeding on weight loss and recovery of pregestational weight in adolescent and adult mothers. Food Nutr Bull. 2013 Jun;34(2):123-30. Abstract
  7. Cheung BM, Cheung TT, Samaranayake NR. Safety of antiobesity drugs. Ther Adv Drug Saf. 2013 Aug;4(4):171-81. Abstract
  8. UDS. Amfepramone. Drug Summary. 2011 Full text (in our servers)
  9. Hatsu IE, McDougald DM, Anderson AK. Effect of infant feeding on maternal body composition. Int Breastfeed J. 2008 Aug 6;3:18. Abstract
  10. Dewey KG. Impact of breastfeeding on maternal nutritional status. Adv Exp Med Biol. 2004;554:91-100. Review. Abstract
  11. OMS. Comité de Expertos de la OMS en Farmacodependencia. Examen crítico de psicofármacos. OMS. Serie de informes técnicos, 33 informe. 2003 Full text (in our servers)
  12. WHO Expert Committee on Drug Dependence. Critical review of psychoactive substances. WHO Technical Report Series. Thirty-third Report 2003 Full text (link to original source) Full text (in our servers)
  13. Dewey KG, Cohen RJ, Brown KH, Rivera LL. Effects of exclusive breastfeeding for four versus six months on maternal nutritional status and infant motor development: results of two randomized trials in Honduras. J Nutr. 2001 Feb;131(2):262-7. Abstract Full text (link to original source) Full text (in our servers)
  14. AEMPS Retirada del mercado de los medicamentos anorexígenos de acción central. 2000 Full text (in our servers)
  15. Dewey KG, Heinig MJ, Nommsen LA. Maternal weight-loss patterns during prolonged lactation. Am J Clin Nutr. 1993 Aug;58(2):162-6. Abstract
  16. Kramer FM, Stunkard AJ, Marshall KA, McKinney S, Liebschutz J. Breast-feeding reduces maternal lower-body fat. J Am Diet Assoc. 1993 Apr;93(4):429-33. Abstract

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