LGS5 asked
If I take 20 mg of regular adderall (not the extended release) at 7 am will it be out of my system by 7pm and would it be safe to breastfeed at that time? I asked the pediatrician and he said it should be fine but I’m still nervous!
Answer
Adderall (Dextroamphetamine and Amphetamine) is a stimulant used in the treatment of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. There are a couple of considerations to take into account when answering the question of when you can breastfeed after taking Adderall.
Some considerations when making this decision are:
- The drug properties of Adderall (Dextroamphetamine and Amphetamine).
- Studies about Adderall (Dextroamphetamine and Amphetamine) and breastfeeding.
- Recommendations of the drug manufacturer and the American Academy of Pediatrics.
Drug Properties Of Adderall
According to the prescribing information, Adderall is distributed and found in human breast milk. Therefore, per the prescribing information, mothers taking Adderall should refrain from breastfeeding while on this drug.
Now, to get a good idea of how long a drug, like Adderall, lasts in the body is to look at its half-life (i.e. time it takes for 50% of a drug to be metabolized in the body).
For Adderall, the half life is around 10-13 hours. This means that there will still be approximately half the amount of the drug present in your body 12 hours after the initial dose. As we know Adderall is distributed in the breast milk, a nursing child would be exposed to Adderall even 12 hours after a dose of Adderall is taken.
What Do Studies Day Regarding Breastfeeding On Adderall?
There are not many studies looking into the effect of Adderall on breastfed infants or children. However the few that are available give us a good look into safety concerns.
One study followed 4 breastfed infants whose mothers were taking dextroamphetamine (which is contained in Adderall). When the breast milk was tested, dextroamphetamine was found in measurable concentrations and some of the infants in the study had measurable concentrations of dextroamphetamine in their blood. The good news is that the infants in this study did not show any detrimental effects from being exposed to dextroamphetamine, although the long term effects aren't known.
Another study, followed a woman being treated for narcolepsy with an amphetamine drug who also nursed. Her breast fed infant showed no adverse events at 10 months of age but amphetamine was found again in both breast milk and blood of the infant. The researchers noted again that further studies of use in breastfeeding and pregnancy are needed.
Recommendations Regarding Breastfeeding While On Adderall
As noted above, the drug manufacturer of Adderall recommends to refrain from nursing while on this medication.
The American Academy of Pediatrics (AAP) lists amphetamines, like Adderall (Dextroamphetamine and Amphetamine), as a drug that should not be used by nursing mothers. The AAP specifically lists irritability and poor sleeping patterns as concerns. At the very least, you should be aware of the potential side effects in infants and be on the look-out for them.
Having said all of the above, there may be situations where Adderall use while nursing is warranted if the benefits outweigh the risks. It is important to speak with your doctor and discuss your concerns and possibility of alternative therapies.
Summary
- Adderall is present in the breast milk when taken by nursing mothers.
- Adderall has a relatively long half-life and will be present in the body for a considerable amount of time after dosing, making it near impossible to avoid infant exposure if taking daily.
- Adderall can be detected in the blood of infants who nurse from mothers that take Adderall.
- Small studies did not notice side effects in infants who nursed from mothers taking Adderall in the short term. However, it cannot be determined if there are any adverse effects to a nursing infant long term.
