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I've been researching online for the longest time now trying to seek answers for my friend. She abuses Adderall and shes breastfeeding. Shes too scared to ask her doctor how long it stays in her system and when can she start breastfeeding again after her last dose. When she does take it, she uses frozen breastmilk to nurse her baby and she usually starts nursing again 24 hours after her last dose. I'm not talking 20mg, she pops about 60 mg of Adderall (orange football shaped ones) at a time. Im just trying to ifnd some sort of answers for her. When can she start breastfeeding after her last dose was taken?
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Sandra13:
Adderall is just another name for dextroamphetamine. Any breastfeeding mother who abuses this product should not be breastfeeding. It has about a 12 hour half-life and after taking 60 mg, she'd need to be very careful about breastfeeding. Below is some actual data on a mom taking 80 mg per day.
Someone needs to counsel this mom.
Tom Hale Ph.D.
Following a 20 mg daily dose of racemic amphetamine administered at 10:00, 12:00, 14:00, and 16:00 hours each day (total= 80 mg/day) to a breastfeeding mother, amphetamine concentrations were determined in milk at 10 days and 42 days postpartum. Samples were taken at 20 min prior to the 10:00 hour dose and immediately prior to the 14:00 hour dose. Milk levels were 55 and 118 ?g/L respectively.[1] Corresponding maternal plasma levels were 20 and 40 ng/mL at the same times. Milk/plasma ratios at these times were 2.8 and 3.0 respectively. At 42 days, breastmilk levels of amphetamine were 68 and 138 ?g/L while maternal plasma levels were 9 and 21 ng/mL respectively. Milk/plasma ratios in the 42-day samples were 7.5 and 6.6 respectively. Although the milk/plasma ratios appear high, using a daily milk intake of 150 mL/kg/day, the relative infant dose would be only 1.8% of the weight-normalized maternal dose, which probably accounts for the fact that the infant in this study was unaffected.
In another study of 4 mothers who received 15-45 mg/day dextroamphetamine, the average absolute infant dose was 21 (11-39) ?g/kg/day.[2] The authors suggest the relative infant dose was 5.7% (4-10.6). Plasma levels in the infants ranged from undetectable to 18 ?g/L. No untoward effects were noted in any of the 4 infants.
The above data suggest that with normal therapeutic doses, the dose of dextroamphetamine in milk is probably subclinical. However, abuse of this medication is common. Doses are unknown and sometimes extraordinarily high. Thus mothers should be strongly advised to withhold breastfeeding for 24 hours following the non-clinical use of dextroamphetamine.
This drug is also available as continuous release formulations (Adderall XR). With continuous release formulations, plasma levels are virtually identical to the twice daily dosing system. Thus if a patient is using XR 20 mg, plasma levels are identical to the 10 mg twice daily.
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