Is Amiodarona Safe in Breastfeeding

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

• DrLact safety Score for Amiodarona is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Amiodarona may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Amiodarona 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 Amiodarona .
• It is recommended to evaluate the advantage of not breastfeeding while using Amiodarona Vs not using Amiodarona And continue breastfeeding.
• While using Amiodarona 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 Amiodarona and its active metabolite are somewhat unpredictable, but can be high during breastfeeding. The infant receives an estimated dose of Amiodarona plus desethylAmiodarona ranging from 3.5 to 45% of the mother's weight-adjusted Amiodarona 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 Amiodarona 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 Amiodarona use with periodic monitoring of infant cardiac and thyroid function status,[5][6] especially if only a single dose of Amiodarona is given.[7] Infant serum levels of Amiodarona and desethylAmiodarona 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 Amiodarona therapy have been reported.[2][3][4][10] One mother took Amiodarona 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 Amiodarona or iodine from Amiodarona in breastmilk, although residual Amiodarona 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 Amiodarona causes hypothyroidism in the mother, her milk supply could be diminished.