Last update June 18, 2022

Amoxapine

Low Risk

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

Tricyclic antidepressant derived from loxapine with properties similar to amitriptyline. Inhibits dopamine reuptake. Two to three times daily oral administration.

It is excreted in human milk in a clinically non-significant amount. (Gelenberg 1979)

It can cause hyperprolactinemia and galactorrhea. (Egberts 1997, Koizumi 1986, Robertson 1982, Cooper 1981, Gelenberg 1979, Jaffe 1978)

As there is less published experience than with other antidepressant drugs (Rubin 2004), known safer alternatives may be preferable (Sriraman 2015, Davanzo 2011, ABM 2008), especially during the neonatal period and in case of prematurity.

Women suffering from depression during pregnancy need more breastfeeding support due to their increased risk of breastfeeding problems and early weaning. (Grzeskowiak 2018, Leggett 2017, Venkatesh 2017, Gorman 2012)


See below the information of this related product:

  • Maternal Depression (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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.

Other names

Amoxapine in other languages or writings:

Tradenames

Main tradenames from several countries containing Amoxapine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 18 - 54 %
Molecular weight 314 daltons
Protein Binding 90 %
Tmax 2 hours
8 - 30 hours
M/P ratio 0.2 -
Theoretical Dose 0.02 mg/Kg/d
Relative Dose 2 %

References

  1. Grzeskowiak LE, Leggett C, Costi L, Roberts CT, Amir LH. Impact of serotonin reuptake inhibitor use on breast milk supply in mothers of preterm infants: a retrospective cohort study. Br J Clin Pharmacol. 2018 Jun;84(6):1373-1379. Abstract Full text (link to original source)
  2. Venkatesh KK, Castro VM, Perlis RH, Kaimal AJ. Impact of antidepressant treatment during pregnancy on obstetric outcomes among women previously treated for depression: an observational cohort study. J Perinatol. 2017 Sep;37(9):1003-1009. Abstract
  3. Leggett C, Costi L, Morrison JL, Clifton VL, Grzeskowiak LE. Antidepressant Use in Late Gestation and Breastfeeding Rates at Discharge from Hospital. J Hum Lact. 2017 Nov;33(4):701-709. Abstract
  4. Sriraman NK, Melvin K, Meltzer-Brody S. ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  5. Gorman JR, Kao K, Chambers CD. Breastfeeding among women exposed to antidepressants during pregnancy. J Hum Lact. 2012 Abstract
  6. Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A. Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2011 Abstract
  7. Drugs.com: Amoxapine Data Sheet 2009 Full text (in our servers)
  8. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #18: use of antidepressants in nursing mothers. Breastfeed Med. 2008 Abstract Full text (link to original source) Full text (in our servers)
  9. Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS-acting drugs. Can J Clin Pharmacol. 2004 Fall;11(2):e257-66. Epub 2004 Dec 8. Abstract
  10. Egberts AC, Meyboom RH, De Koning FH, Bakker A, Leufkens HG. Non-puerperal lactation associated with antidepressant drug use. Br J Clin Pharmacol. 1997 Abstract Full text (link to original source) Full text (in our servers)
  11. Koizumi K, Aono T, Tanizawa O. The acute effects of antidepressants, maprotiline and amoxapine on serum prolactin and gonadotropin levels in normal women. Asia Oceania J Obstet Gynaecol. 1986 Abstract
  12. Robertson AG, Berry R, Meltzer HY. Prolactin stimulating effects of amoxapine and loxapine in psychiatric patients. Psychopharmacology (Berl). 1982 Abstract
  13. Cooper DS, Gelenberg AJ, Wojcik JC, Saxe VC, Ridgway EC, Maloof F. The effect of amoxapine and imipramine on serum prolactin levels. Arch Intern Med. 1981 Abstract
  14. Gelenberg AJ, Cooper DS, Doller JC, Maloof F. Galactorrhea and hyperprolactinemia associated with amoxapine therapy. Report of a case. JAMA. 1979 Abstract
  15. Gelenberg AJ. Single case study. Amoxapine, a new antidepressant, appears in human milk. J Nerv Ment Dis. 1979 Abstract
  16. Jaffe K, Zisook S. Galactorrhea in a patient treated with amoxapine. J Clin Psychiatry. 1978 Abstract

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