Last update July 7, 2023

Metamfetamine Hydrochloride (MA)

Limited compatibility

Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

Metamfetamine is a sympathomimetic drug, powerful stimulant of the central nervous system, whose action and uses are similar to dextroamphetamine. It has been used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), but above all it is considered an illegal drug (Chomchai, 2016; Bartu, 2009). It is partially metabolized to amphetamine and it has strong psychotic, addiction and abuse potential. (Vallersnes 2016, Courtney 2014, Carvalho 2012)

It is excreted in breast milk (Chomchai, 2016; Bartu, 2009), with a slower elimination than in plasma, as the half-life in milk is 40 hours, disappearing completely from the milk 1 day before the values ​​in urine are negative. (Chomchai 2016)

A breastfeeding mother who inhaled methamphetamine was accused of the cot death of her 2-month-old baby, although there has been some question as to whether methamphetamine in milk was the cause. (Green 1996, Ariagno 1995)

There is little information on the impact of amphetamine abuse on infant development and health (Oei 2012), but it is known that they are more exposed to social problems, domestic violence, and lower rates of breastfeeding. (Shah 2012, Oei 2010).

Amphetamines do not cause significant decreases in prolactin levels (DeLeo 1983). Methamphetamine withdrawal caused increased prolactin secretion. (Zorick 2011)

Its recreational use is strongly discouraged (Oei, 2012). Drug abuse behavior incapacitates the mother for appropriate baby care and poses a life hazard for both the mother and the infant.

To avoid exposure to the infant and minimize the risk, after the last recreational use of amphetamine, it is advisable to wait 85 hours (5 T ½, which eliminates 97% of the substance) before breastfeeding again. For other authors it is enough to wait 2 days (Bartu 2009) or 4 days (Chomchai 2016) or, more safely, when the detection in the mother's urine is negative (Chomchai 2016). Meanwhile, express and discard milk from the breast regularly to maintain production.


See below the information of these related products:

  • Amfetamine (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Dexamfetamine Sulfate (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

Alternatives

  • Dexamfetamine Sulfate (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Lisdexamfetamine Mesilate (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Methylphenidate (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Metamfetamine Hydrochloride (MA) is also known as


Metamfetamine Hydrochloride (MA) in other languages or writings:

Groups

Metamfetamine Hydrochloride (MA) belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Metamfetamine Hydrochloride (MA) in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 67 - 90 %
Molecular weight 186 daltons
Protein Binding ≈ 20 %
VD 3 - 5 l/Kg
pKa ≈ 10 -
Tmax 5 - 6 hours
9.1 (3 - 17) hours
Theoretical Dose 0.02 - 0.05 mg/Kg/d

References

  1. Chomchai C, Chomchai S, Kitsommart R. Transfer of Methamphetamine (MA) into Breast Milk and Urine of Postpartum Women who Smoked MA Tablets during Pregnancy: Implications for Initiation of Breastfeeding. J Hum Lact. 2016 May;32(2):333-9. Abstract
  2. Vallersnes OM, Dines AM, Wood DM, Yates C, Heyerdahl F, Hovda KE, Giraudon I; Euro-DEN Research Group., Dargan PI. Psychosis associated with acute recreational drug toxicity: a European case series. BMC Psychiatry. 2016 Aug 18;16:293. Abstract Full text (link to original source)
  3. Courtney KE, Ray LA. Methamphetamine: an update on epidemiology, pharmacology, clinical phenomenology, and treatment literature. Drug Alcohol Depend. 2014 Oct 1;143:11-21. Abstract
  4. Shah R, Diaz SD, Arria A, LaGasse LL, Derauf C, Newman E, Smith LM, Huestis MA, Haning W, Strauss A, Della Grotta S, Dansereau LM, Roberts MB, Neal C, Lester BM. Prenatal methamphetamine exposure and short-term maternal and infant medical outcomes. Am J Perinatol. 2012 May;29(5):391-400. Abstract
  5. Oei JL, Kingsbury A, Dhawan A, Burns L, Feller JM, Clews S, Falconer J, Abdel-Latif ME. Amphetamines, the pregnant woman and her children: a review. J Perinatol. 2012 Oct;32(10):737-47. Abstract Full text (link to original source) Full text (in our servers)
  6. Carvalho M, Carmo H, Costa VM, Capela JP, Pontes H, Remião F, Carvalho F, Bastos Mde L. Toxicity of amphetamines: an update. Arch Toxicol. 2012 Aug;86(8):1167-231. Abstract
  7. Zorick T, Mandelkern MA, Lee B, Wong ML, Miotto K, Shabazian J, London ED. Elevated plasma prolactin in abstinent methamphetamine-dependent subjects. Am J Drug Alcohol Abuse. 2011 Jan;37(1):62-7. Abstract
  8. Oei J, Abdel-Latif ME, Clark R, Craig F, Lui K. Short-term outcomes of mothers and infants exposed to antenatal amphetamines. Arch Dis Child Fetal Neonatal Ed. 2010 Jan;95(1):F36-41. Abstract
  9. Bartu A, Dusci LJ, Ilett KF. Transfer of methylamphetamine and amphetamine into breast milk following recreational use of methylamphetamine. Br J Clin Pharmacol. 2009 Apr;67(4):455-9. Abstract Full text (link to original source) Full text (in our servers)
  10. Cruickshank CC, Dyer KR. A review of the clinical pharmacology of methamphetamine. Addiction. 2009 Jul;104(7):1085-99. Abstract
  11. de la Torre R, Farré M, Navarro M, Pacifici R, Zuccaro P, Pichini S. Clinical pharmacokinetics of amfetamine and related substances: monitoring in conventional and non-conventional matrices. Clin Pharmacokinet. 2004;43(3):157-85. Review. Abstract
  12. Green LS. People v Henderson: the prosecution responds. JAMA. 1996 Jan 17;275(3):183-4. No abstract available. Abstract
  13. Ariagno R, Karch SB, Middleberg R, Stephens BG, Valdès-Dapena M. Methamphetamine ingestion by a breast-feeding mother and her infant's death: People v Henderson. JAMA. 1995 Jul 19;274(3):215. No abstract available. Abstract
  14. DeLeo V, Cella SG, Camanni F, Genazzani AR, Müller EE. Prolactin lowering effect of amphetamine in normoprolactinemic subjects and in physiological and pathological hyperprolactinemia. Horm Metab Res. 1983 Sep;15(9):439-43. Abstract

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