shaun asked
How long would 20 mg of Adderall XR remain in my breast milk? I want to pump before I take it and bottle-feed my three-month-old until it's been metabolized out. Thanks!
Answer
It is recommended to try and avoid the use of amphetamines while breast feeding because it is readily excreted in the breast milk. If it must be used, the infant that is nursing should be monitored for signs of drug exposure including irritability, decreased appetite and insomnia. Having said that, let's take a look at how long it takes metabolize Adderall XR. According to data regarding the drug, it appears that maximum absorption of Adderall XR will take place within 7 hours. The half life of the drug (the time is takes 50% of the drug to be metabolized and excreted) is thought to be around 10-13 hours in adults. Based on this information, if you take Adderall XR daily, it would not be possible to avoid having the drug present in breastmilk at all times. Obviously the longer the time between doses a lesser amount of drug should make it's way into the breast milk. The recommendation would just be to separate your dose, and the time you pump/feed by as much time as possible if you need to stay on Adderall for medical reasons.
I should note that there have been studies looking into the possible problems with breastfeeding and Adderall administration. One such study that I found (Steiner E, Villen T, Hallberg M, et al. Amphetamine secretion in breast milk. Eur J Clin Pharmacol 1984;27:123-4) states that although Adderall is excreted in the beast milk, no side effects were noted in the infants studied. The best recommendation would be to separate doing and breastfeeding by as much time as possible, and to monitor to infant for side effects.
So while we won't be able to get an EXACT answer for you, we can probably give you a pretty good idea of when would be safe.
In terms of the half life of 10-13 hours I mentioned, we can get a pretty good idea of how long it will take for most of the drug to leave the body. We will use 13 hours for this example.
- 13 Hours: 50% of the drug is left in the body
- 26 Hours: 25% of the drug is left
- 39 Hours: 12.5% of the drug is left
- 52 hours: 6.25% of the drug is left
- 65 hours: 3.125% of the drug is left
- 78 hours: 1.56% if the drug is left
So, at 78 hours (3 1/4 days) there is a minimal amount of drug left in the body (~1.56%). This is very much in line with drug testing for amphetamine products. Typically, depending on the person, amphetamine products can be detected in the urine for 2-4 days after someone ingests it according to the Center for Substance Abuse Treatment. After 4 days, there would be less than 1% of the drug left in your body and would therefore not be detected.
So, as stated before, we can't get a perfect time as to when you can breastfeed, but we get a good idea. While around 4 days would be absolutely ideal to be assured that an extremely minimal amount with the drug will be in the breast milk, anything after that 52 hours mark ( 2 days and 6 hours) shouldn't produce too many problems for you.
