毒理性
◉ 母乳喂养期间使用总结：在一些为医疗指征开具的剂量下，有证据表明安非他命对哺乳婴儿没有不利影响。安非他命在乳汁中对婴儿神经发育的影响尚未得到充分研究。大剂量的安非他命可能会干扰乳汁生产，尤其是在哺乳尚未建立的妇女中。通常不鼓励在积极滥用安非他命的的母亲中进行母乳喂养。一位专家建议，在哺乳母亲中不应将安非他命用于治疗目的。
◉ 对哺乳婴儿的影响：一位母亲因治疗嗜睡症而服用消旋安非他命5毫克，每天四次，在哺乳期间（未指明时长）婴儿接触了乳汁中的药物。在生命的前两年内没有出现发育异常的迹象。
一位母亲在孕期和产后每天服用安非他命35毫克治疗嗜睡症，她的婴儿在出生后头六个月进行了纯母乳喂养。婴儿没有出现不良反应，并且正常成长。
◉ 对泌乳和母乳的影响：在同一作者的两篇论文中，研究了20名在产后第2或3天具有正常生理性高催乳素血症的妇女。其中8人接受了右旋安非他命7.5毫克静脉注射，6人接受了15毫克静脉注射，6人作为对照组接受了静脉注射生理盐水。7.5毫克剂量使血清催乳素降低了25至32%，与对照组相比差异无统计学意义。15毫克剂量在输液后显著降低了血清催乳素30至37%。没有提供乳汁产量的评估。作者还引用了另一项研究的数据，显示20毫克口服剂量的右旋安非他命在产后妇女中产生了40%的血清催乳素持续抑制。在已经建立哺乳的母亲中，母体催乳素水平可能不会影响她的哺乳能力。
在一项回顾性澳大利亚研究中，使用静脉安非他命的母亲在出院时比使用其他药物的母亲更不可能在哺乳新生儿（27%对42%）。这种差异的原因尚未确定。
一位母亲在孕期和产后每天服用安非他命35毫克治疗嗜睡症。她纯母乳喂养婴儿6个月，没有证据表明对乳汁生产有不利影响。
◉ Summary of Use during Lactation:In dosages prescribed for medical indications, some evidence indicates that amphetamine does not affect nursing infants adversely. The effect of amphetamine in milk on the neurological development of the infant has not been well studied. Large dosages of amphetamine might interfere with milk production, especially in women whose lactation is not well established. Breastfeeding is generally discouraged in mothers who are actively abusing amphetamines. One expert recommends that amphetamine not be used therapeutically in nursing mothers.
◉ Effects in Breastfed Infants:One infant whose mother was being treated for narcolepsy with racemic amphetamine 5 mg 4 times daily was exposed to the drug in milk for the (unspecified) duration of breastfeeding. There were no signs of abnormal development during the first 2 years of life.
The infant of a mother who was taking amphetamine 35 mg daily for narcolepsy during pregnancy and postpartum was exclusively breastfed for 6 months. The infant experienced no adverse reactions and grew normally.
◉ Effects on Lactation and Breastmilk:In 2 papers by the same authors, 20 women with normal physiologic hyperprolactinemia were studied on days 2 or 3 postpartum. Eight received dextroamphetamine 7.5 mg intravenously, 6 received 15 mg intravenously and 6 who served as controls received intravenous saline. The 7.5 mg dose reduced serum prolactin by 25 to 32% compared to control, but the difference was not statistically significant. The 15 mg dose significantly decreased serum prolactin by 30 to 37% at times after the infusion. No assessment of milk production was presented. The authors also quoted data from another study showing that a 20 mg oral dose of dextroamphetamine produced a sustained suppression of serum prolactin by 40% in postpartum women. The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.
In a retrospective Australian study, mothers who used intravenous amphetamines during pregnancy were less likely to be breastfeeding their newborn infants at discharge than mothers who abused other drugs (27% vs 42%). The cause of this difference was not determined.
A mother took amphetamine 35 mg daily for narcolepsy during pregnancy and postpartum. She exclusively breastfed her infant for 6 months with no evidence of an adverse effect on milk production.
来源:Drugs and Lactation Database (LactMed)
