Has anyone taken Elavil (amitriptyline) while breastfeeding?

Question

I have daily headaches and have taken Elavil in the past. I discountinued taking it when I became pregnant with my now 6 month old daughter. My doctor has put me back on it but I am very anxious about taking it. He said there isn't much known about the effects to an infant. He said very little is transferred through breastmilk...but I am still concerned. I am stuck because I can't stand having this pain on a daily basis but I also do not want to harm my daughter. I will feel a lot better if I know of other people that have taken it while breasfeeding and if their children did fine.

Answer 1

Amitriptyline (Elavil) is rated Lactation Risk Category L2 in the book "Medications & Mother's Milk" by Thomas Hale. Dr. Hale is *THE* expert on medications and breastfeeding. L2 means "Safer." (Drugs are rated L1 through L2 with L1 being safest and L5 being a big no-no.)

Per Hale:
"Amitriptyline and its active metabolite, nortriptyline, are secreted into breastmilk in small amounts. In one report of a mother taking 100 mg/day or amitriptyline, milk levels of amitriptyline and nortriptyline (active metabolite) averaged 143 ug/L and 55.5 ug/L, respectively, maternal serum levels averaged 112 ug/L and 72.5 ug/L, respectively. No drug was detected in the infants serum. From this data, an infant would consume approximately 21.5 ug/kg/day, a dose that is unlikely to be clinically relevant.

In another study following a maternal dose of 25 mg/day, the amitriptyline and nortriptyline (active metabolite) levels in milk were 30 ug/L and < 30 ug/L respectively. In the same study when the dosage was 75 mg/day, milk levels of amitriptyline and nortriptyline averaged 88 ug/L and 69 ug/L respectively. Both drugs were essentially undetectable in the infant's serum. Therefore, the authors estimated that a nursing infant would receive less than 0.1 mg/day."

Under "Pediatric Concerns" Hale says:
"No untoward effects have been noted in several studies."

You can ask your local LLL Leader or Lactation Consultant to make a copy of the info from Hales if you would like to share it with your doctor. It sounds like Hale feels it is a very safe option to me.

Answer 2

Amitriptyline And Breastfeeding

Answer 3

i also take Elavil for migraines...i was told that you shouldnt take it if you are breastfeeding...here are a few things i had taken or done to aleviate the headaches while pregnant and or breastfeeding..my OB/GYN put me on Fioricet, takes the headache away fairly quickly...then we tried Nadolol, blood pressure lowering meds, it made my life so much nicer because it worked and prevented headaches...

i know your pain..i had a migraine headache for almost the entire 9 months and then 3 months after i had my son...migraines just make you want to curl up in a ball and die..you dont want to get up, or sometimes even associate with the family because you are in so much pain....thats how i was...go back to your doctor and ask about those 2 drugs...i took fioricet and nadolol, while pregnant and breastfeeding and my son is healthy as can be

Answer 4

I did take one or two when breasfeeding, and I know that my daughter hasn't been affected by it. I know also that I was given a list of things that was suitable to take whilst breastfeeding, and amitriptaline was on it.

Your doctor wouldn't have given it if were completely unsafe for use in breastfeeding.

Answer 5

"Amitriptyline passes into breast milk and may affect a nursing baby. Do not take amitriptyline without first talking to your doctor if you are breast-feeding a baby."