Is Amitriptyline compatible with breastfeeding? Do we have alternatives for Amitriptyline?

Amitriptyline

January 29, 2017 (Very Low Risk)

It is excreted into breastmilk in a clinically non-significant amount (Bader 1980, Brixen 1982, Pittard 1986, Breyer 1995, Yoshida 1999).

Plasma levels in the infant have been found undetectable (Ericsson 1979, Bader 1980, Brixen 1982, Breyer 1995) or very low (Yoshida 1997) and no side effects being observed even at maternal doses as high as 150-175 mg / day (Brixen 1982 , Misri 1991, Yoshida 1999, Nulman 2002).
However, one published case of sedation on a 15-day-old infant that occured within few days after taken just 10 mg daily of amitriptyline by her mother because of insomnia and anxiety (Oguz 2016). Levels were not measured in either milk or plasma of the infant and the mother.

Amitriptyline may produce galactorrhoea by prolactin stimulation.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Amitriptyline Embonate
  • Amitriptyline Hydrochloride

Writings

  • أميتريبتيلين (Arabic)
  • Амитриптилин (Cyrillic)
  • 阿米替林 (Chinese)
  • アミトリプチリン (Japanese)
  • C20H23N (Molecular formula)

References

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