Is Aminophylline safe while breastfeeding?

Effects on the breastfed infant

Irritability and fretful sleeping occurred in a 3-day-old breastfed infant on days of maternal aminophylline intake of 200 mg every six hours. These effects ceased with discontinuation and recurred on rechallenge over the next 9 months. These effects were probably caused by theophylline in breastmilk. Another five infants reported in this paper showed no adverse reactions after maternal theophylline ingestion.[ 3 ] Accumulation of theophylline in infant serum appears most likely in neonates and premature infants because they eliminate theophylline slowly.[ 2 , 5 ]

Effects on milk supply

Relevant published information was not found as of the revision date.

Levels in milk

Aminophylline is a salt of theophylline, which is the active drug found in maternal serum and breastmilk after aminophylline ingestion. Maternal Levels. Theophylline rapidly equilibrates between plasma and milk. Peak milk levels occur 1 to 3 hours after oral ingestion of immediate-release products and almost immediately after intravenous administration. Milk levels parallel serum levels closely and average about 70% of simultaneous maternal serum levels.[ 2 , 3 ] Assuming that each 1 mg/kg of maternal theophylline increases her serum level by 2 mg/L, an exclusively breastfed infant would receive about 21% of the maternal weight-adjusted dosage of theophylline or 17% of the maternal dosage of aminophyllline. Infant Levels. Theophylline is found in the serum of breastfed infants.[ 4 ] In newborn infants with typical theophylline clearance rates, infant serum levels are expected to be between 1 and 4 mg/L with a maternal serum level in the therapeutic range of 10 to 20 mg/L.[ 2 ] Infant serum levels might occasionally accumulation to therapeutic levels in infants with slow clearance rates of the drug.[ 5 ]

Alternatives LactMed lists

• Terbutaline