Last update: April 23, 2021

Dexamfetamine Sulfate

Low Risk for breastfeeding


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

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.


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Other names

Dexamfetamine Sulfate is also known as


Dexamfetamine Sulfate in other languages or writings:

Groups

Dexamfetamine Sulfate belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Dexamfetamine Sulfate in its composition:

List of 9 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 369 daltons
Protein Binding 16 - 20 %
VD 3,2 - 5,6 l/Kg
pKa ≈ 10 -
Tmax 3 - 8 hours
T1/2 10 - 11 hours
M/P ratio 3,3 (2,2 - 4,8) -
Theoretical Dose 0,02 (0,01 - 0,04) mg/Kg/d
Relative Dose 5,7 (4 - 10,6) %

References

  1. Öhman I, Wikner BN, Beck O, Sarman I. Narcolepsy Treated with Racemic Amphetamine during Pregnancy and Breastfeeding. J Hum Lact. 2015 Abstract
  2. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  3. 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 Oct;32(10):737-47. Abstract Full text (link to original source) Full text (in our servers)
  4. 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 Jan;95(1):F36-41. Abstract
  5. 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)
  6. 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
  7. GSK. Dextroamphetamine. Drug Summary. 2007 Full text (in our servers)
  8. de la Torre R, Farré M, Navarro M, Pacifici R, Zuccaro P, Pichini S. Clinical pharmacokinetics of amfetamine and related substances: monitoring in conventional and non-conventional matrices. Clin Pharmacokinet. 2004;43(3):157-85. Review. Abstract
  9. 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)
  10. 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
  11. 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 Sep;15(9):439-43. Abstract

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