Transfer of dexamphetamine into breast milk during treatment for attention deficit hyperactivity disorder

What is already known about this subject

• There are presently no published data on dexamphetamine transfer into breast milk or on its effects in the breast‐fed infant.

What this study adds

• We have provided quantitative data on the absolute and relative infant doses of dexamphetamine for the breast‐fed infant.

Aims

To investigate dexamphetamine transfer into milk, infant doses and effects in the breast‐fed infant.

Methods

Four women taking dexamphetamine, and their infants were studied.

Results

The median maternal dexamphetamine dose was 18 mg day⁻¹ (range 15–45 mg day⁻¹). Median (interquartile range) descriptors were 3.3 (2.2–4.8) for milk/plasma ratio, 21 µg kg⁻¹ day⁻¹ (11–39) for absolute infant dose and 5.7% (4–10.6%) for relative infant dose. No adverse effects were seen. In three infants tested, dexamphetamine in plasma was undetected in one (limit of detection 1 µg l⁻¹) and present at 18 µg l⁻¹ and 2 µg l⁻¹ in the other two.

Conclusion

Dexamphetamine readily transfers into milk. The relative infant dose was <10% and within a range that is generally accepted as being ‘safe’ in the short term.

DOI: 10.1111/j.1365-2125.2006.02767.x

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