This sheet is about exposure to dextroamphetamine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is dextroamphetamine?
Dextroamphetamine, also known as dexamphetamine or d-amphetamine, is a prescription stimulant that belongs to a group of medications called amphetamines. Dextroamphetamine has been used to treat attention deficit hyperactivity disorder (ADHD), narcolepsy (a condition causing extreme daytime sleepiness), and some mental health conditions. Some brand names are Dexedrine®, Dexedrine Spansules®, Dextrostat®, Liquadd®, ProCentra®, and Zenzedi®.
Lisdexamfetamine (Vyvanse®) is a medication that has been used to treat ADHD and binge eating disorders. In the body, lisdexamfetamine breaks down into dextroamphetamine. Information about dextroamphetamine in pregnancy can be used to help understand possible effects of lisdexamfetamine. Dextroamphetamine can be combined with amphetamine salts to create mixed amphetamine salts, a medication known by brand name Adderall®. For more information on Adderall®, please see our fact sheet at https://mothertobaby.org/fact-sheets/dextroamphetamine-amphetamine-adderall/. Dextroamphetamine is different from methamphetamine. Please see our fact sheet on methamphetamine at https://mothertobaby.org/fact-sheets/methamphetamine/.
Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Stopping this medication suddenly can cause withdrawal. It is not known if or how withdrawal may affect a pregnancy. If you are going to stop using this medication, your healthcare providers may talk with you about slowly reducing your dose over time. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
I take dextroamphetamine. Can it make it harder for me to get pregnant?
It is not known if dextroamphetamine can make it harder to get pregnant.
Does taking dextroamphetamine increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies that looked at pregnancies exposed to prescribed amphetamines as a group have not shown a consistent increase in the chance of miscarriage. One study that included 130 pregnancies exposed to dextroamphetamine did not find a clear increase in miscarriage. A study found that over 500 women who continued dextroamphetamine throughout pregnancy were less likely to have a threatened miscarriage (bleeding and/or cramping) than women who stopped the medication in pregnancy.
Does taking dextroamphetamine increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like dextroamphetamine, might increase the chance of birth defects in a pregnancy. Studies looking at women who take dextroamphetamine as prescribed have not reported an increased chance of birth defects.
Does taking dextroamphetamine increase the chance of other pregnancy-related problems?
A study of over 500 women who took dextroamphetamine in pregnancy found no significant increase in low birth weight (babies weighing less than 5 pounds, 8 ounces [2,500 grams] at birth) or preterm delivery (birth before week 37) when compared to women with ADHD who stopped their medication.
Larger studies of pregnancies exposed to prescribed amphetamines have shown mixed results. One study reported an increased risk of preterm delivery, while two others found no such link. Some studies reported a higher risk of high blood pressure and preeclampsia (high blood pressure and problems with organs, such as kidneys), whereas others did not. It is also important to note that conditions treated with amphetamines, such as ADHD, may increase the chance of preterm delivery or high blood pressure during pregnancy.
Using amphetamine medications at higher doses or more often than prescribed, or using them without a prescription, can increase the chance of poor growth (babies born small and/or with small head size), low birth weight, and preterm delivery. These studies often included pregnancies that might have had other risk factors that can increase the chance of these pregnancy-related problems.
I need to take dextroamphetamine during my pregnancy. Will it cause withdrawal symptoms in my baby after birth?
Withdrawal has not been reported in the newborns of women who are taking dextroamphetamine as prescribed by their healthcare providers. Using amphetamine medications at higher doses or more often than prescribed, or using them without a prescription, can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. They can include jitteriness, sleepiness, and trouble breathing at the time of birth. It is important that your healthcare providers know about your exposures in pregnancy so that if symptoms occur, your baby can get the care that is best for them.
Does taking dextroamphetamine in pregnancy affect future behavior or learning for the child?
No studies have looked at future behavior or learning in children after exposure to dextroamphetamine alone. A study looking at over 7000 pregnancies in which the mother was prescribed dextroamphetamine-amphetamine mixed salts in the second half of pregnancy showed no increased chance of neurodevelopmental conditions, including autism and ADHD. Another study looking at over 300 pregnancies prescribed amphetamines as a group showed no increased chance of neurodevelopmental conditions compared to those who stopped their medication before getting pregnant. Prescription-based studies cannot tell us if the woman who filled the prescription took the medication during their pregnancy.
Breastfeeding while taking dextroamphetamine:
When dextroamphetamine is taken as directed, it passes into breast milk in small amounts. A small study of 4 infants who were breastfed by mothers taking dextroamphetamine for ADHD found no problems in the infants’ health and growth up to 6 to 10 months of age. Another study that included 13 infants breastfeed by mothers taking amphetamine medication found no problems with neurodevelopment at the average age of 18 months. If you suspect the baby has any symptoms such as trouble eating, trouble sleeping, extra sleepiness, or irritability, contact the child’s healthcare provider.
The product labels for some dextroamphetamine products recommend women who are breastfeeding not use these medications. But the benefits of using dextroamphetamine and breastfeeding might outweigh possible risks. The product labels also suggests that large doses of dextroamphetamine could lower milk supply in women who are newly breastfeeding. However, there are no clear reports showing that this happens. Your healthcare providers can talk with you about using dextroamphetamine and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man takes dextroamphetamine, could it affect fertility or increase the chance of birth defects?
Men’s fertility (ability to make healthy sperm) may be impacted by amphetamine medications. One study suggested using these medications may lower the amount of sperm that is made. Studies have not been done to see if dextroamphetamine specifically could affect fertility or increase the chance of birth defects. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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