Is Amiodarone Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Amiodarone? Is Amiodarone safe for nursing mother and child? Does Amiodarone extracts into breast milk? Does Amiodarone has any long term or short term side effects on infants? Can Amiodarone influence milk supply or can Amiodarone decrease milk supply in lactating mothers?

• DrLact safety Score for Amiodarone is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Amiodarone may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Amiodarone may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using Amiodarone .
• It is recommended to evaluate the advantage of not breastfeeding while using Amiodarone Vs not using Amiodarone And continue breastfeeding.
• While using Amiodarone Its must to monitor child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
• Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

A published case of infant hypothyroidism. Others have reported lab controlled cases with harmless effect in breastfed babies.

Breastmilk and infant serum levels of amiodarone and its active metabolite are somewhat unpredictable, but can be high during breastfeeding. The infant receives an estimated dose of amiodarone plus desethylamiodarone ranging from 3.5 to 45% of the mother's weight-adjusted amiodarone dose, with a median dose of about 11%.[1][2][3][4] Infant serum levels of the drug plus metabolite range from 14 to 74% of simultaneous maternal levels, with the higher values reflecting transplacental passage of the drug.[2][3][4] In addition to possible cardiac effects, these compounds contain a large amount of iodine which may be released during metabolism. Thyroid dysfunction was reported in one breastfed infant. Even if the drug were discontinued at birth, the mother would continue to excrete amiodarone and its metabolite (and possibly large amounts of iodine) into breastmilk for days to weeks. Some investigators believe that breastfeeding can be undertaken during maternal amiodarone use with periodic monitoring of infant cardiac and thyroid function status,[5][6] especially if only a single dose of amiodarone is given.[7] Infant serum levels of amiodarone and desethylamiodarone may be useful for ruling out cardiac effects of the drug. If hypothyroidism develops, therapy should be promptly initiated.

Several infants who breastfed without apparent harm during maternal amiodarone therapy have been reported.[2][3][4][10] One mother took amiodarone during the last 5 weeks of pregnancy and until one week after delivery. She was also taking metoprolol throughout pregnancy and at the time of delivery. Possible signs of hypothyroidism occurred transiently in her breastfed infant at 9 and 24 days of age. This was possibly caused by amiodarone or iodine from amiodarone in breastmilk, although residual amiodarone from transplacental passage is also a possible contributing factor; no abnormalities in cornea or the lungs were found.[4]

Relevant published information was not found as of the revision date. However, if amiodarone causes hypothyroidism in the mother, her milk supply could be diminished.