Amoxapine use while Breastfeeding
Drugs containing Amoxapine: Asendin
Amoxapine Levels and Effects while Breastfeeding
Summary of Use during Lactation
Because no information is available on the use of amoxapine during breastfeeding, another drug may be preferred, especially while nursing a newborn or preterm infant. If amoxapine is required by the mother, it is not a reason to discontinue breastfeeding. Exclusively breastfed infants should be monitored if this drug is used during lactation, possibly including measurement of serum levels to rule out toxicity if there is a concern.
Maternal Levels.In one nonbreastfeeding woman who developed galactorrhea during use of amoxapine 250 mg daily, amoxapine was found to be qualitatively present at less than 20 mcg/L, but not quantifiable at 0.75 and 11.5 hours after the dose. Milk levels of 8-hydroxyamoxapine, an active metabolite of amoxapine, were 113 and 168 mcg/L at 0.75 and 11.5 hours after the dose, respectively. No data are available on amoxapine in breastfeeding women.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Effects on Lactation and Breastmilk
Two cases of galactorrhea have been reported in nonbreastfeeding women who were taking amoxapine. The clinical relevance of these findings in nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
An observational study looked at outcomes of 2859 women who took an antidepressant during the 2 years prior to pregnancy. Compared to women who did not take an antidepressant during pregnancy, mothers who took an antidepressant during all 3 trimesters of pregnancy were 37% less likely to be breastfeeding upon hospital discharge. Mothers who took an antidepressant only during the third trimester were 75% less likely to be breastfeeding at discharge. Those who took an antidepressant only during the first and second trimesters did not have a reduced likelihood of breastfeeding at discharge. The antidepressants used by the mothers were not specified.
A retrospective cohort study of hospital electronic medical records from 2001 to 2008 compared women who had been dispensed an antidepressant during late gestation (n = 575) to those who had a psychiatric illness but did not receive an antidepressant (n = 1552) and mothers who did not have a psychiatric diagnosis (n = 30,535). Women who received an antidepressant were 37% less likely to be breastfeeding at discharge than women without a psychiatric diagnosis, but no less likely to be breastfeeding than untreated mothers with a psychiatric diagnosis. None of the mothers were taking amoxapine.
Alternate Drugs to Consider
1. Gelenberg AJ. Amoxapine, a new antidepressant, appears in human milk. J Nerv Ment Dis. 1979;167:635-6. PMID: 573779
2. Jaffe K, Zisook S. Galactorrhea in a patient treated with amoxapine. J Clin Psychiatry. 1978;39:821. PMID: 569147
3. Venkatesh KK, Castro VM, Perlis RH et al. Impact of antidepressant treatment during pregnancy on obstetric outcomes among women previously treated for depression: An observational cohort study. J Perinatol. 2017;37:1003-9. PMID: 28682318
4. Leggett C, Costi L, Morrison JL et al. Antidepressant use in late gestation and breastfeeding rates at discharge from hospital. J Hum Lact. 2017;33:701-9. PMID: 28984528
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Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
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- Drug class: tricyclic antidepressants
Other brands: Asendin