Is Atomoxetine safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Atomoxetine. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
The author of a review article reported that the manufacturer of atomoxetine (Eli Lilly and Co.) had reports of 2 infants who slept longer than usual after being breastfed by mothers who were taking atomoxetine. Neither of the infants experienced any serious adverse events. Dosages, duration of maternal therapy, infant age and extent of breastfeeding were not provided.[ 3 ] Ten women taking atomoxetine in daily doses of 40 to 100 mg and nursing their 11 infants (one pair of twins) responded to a questionnaire concerning their infants health. The infants ages ranged from 11 days to 23 months. Breastfeeding ranged from exclusive to partial breastfeeding for 1 to 3 months during atomoxetine use. None of the mothers reported any suspected adverse effects or delayed development in their infants from drug exposure at the time the survey was completed.[ 1 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Ten women taking atomoxetine in daily doses of 40 to 100 mg donated milk aliquots from both breasts after a complete emptying with a pump and mixing. Mothers were requested to provide milk samples at home at 0, 1, 2, 4, 6, 8, 10, 12, 18, and 24 hours after drug administration at steady-state conditions. Because of the variety of doses used, the mean atomoxetine concentration in milk was adjusted to a daily dose of 80 mg. The average concentration in milk at this dose was 12 mcg/L, resulting in an RID of 0.19%. Using the maximum concentration of 39 mcg/L the worst-case RID would be 0.65%.[ 1 ] A woman taking 40 mg of atomoxetine at bedtime donated breastmilk samples three days after delivery. The concentrations of atomoxetine in breastmilk were below the LLOQ before administration and 2.9 mcg/L at 2 hours after the dose, while 4-hydroxyatomoxetine concentrations were below the LLOQ before administration and 2.1 mcg/L at 2 hours after the dose. The secondary metabolite N -DAT was not detectable in breastmilk.[ 2 ] Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.