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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Amoxapine - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="Drugs and Lactation Database (LactMed®) [Internet]">
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<meta name="citation_title" content="Amoxapine">
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<meta name="citation_publisher" content="National Institute of Child Health and Human Development">
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<meta name="citation_date" content="2022/04/18">
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<meta name="citation_keywords" content="Asendin">
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<meta name="citation_keywords" content="Demolox">
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<meta name="citation_keywords" content="Moxadil">
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<meta name="citation_keywords" content="Amoxan">
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<meta name="citation_keywords" content="Amoxapinum">
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<meta name="citation_keywords" content="Amoxapina">
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<meta name="citation_keywords" content="Desmethylloxapin">
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<meta name="citation_keywords" content="Amoxapinum [INN-Latin]">
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<meta name="citation_keywords" content="Amoxapine [USAN:USP:INN:BAN:JAN]">
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<meta name="citation_keywords" content="2-Chloro-11-(1-piperazinyl)dibenz(b,f)(1,4)oxazepine">
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<meta name="citation_keywords" content="2-Chlor-11-(1-piperazinyl)dibenz(b,f)(1,4)oxazepin">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501183_"><span class="title" itemprop="name">Amoxapine</span></h1><p class="fm-aai"><a href="#_NBK501183_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 2 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 14028-44-5</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134989136" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134989136" alt="image 134989136 in the ncbi pubchem database" /></a><div id="LM320.Drug_Levels_and_Effects"><h2 id="_LM320_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM320.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Because there is no published experience with amoxapine during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.</p></div><div id="LM320.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> In one nonbreastfeeding woman who developed galactorrhea during use of amoxapine 250 mg daily, amoxapine was found to be qualitatively present at less than 20 mcg/L, but not quantifiable at 0.75 and 11.5 hours after the dose. Milk levels of 8-hydroxyamoxapine, an active metabolite of amoxapine, were 113 and 168 mcg/L at 0.75 and 11.5 hours after the dose, respectively.[<a class="bibr" href="#LM320.REF.1" rid="LM320.REF.1">1</a>] No data are available on amoxapine in breastfeeding women.</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM320.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM320.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>Two cases of galactorrhea have been reported in nonbreastfeeding women who were taking amoxapine.[<a class="bibr" href="#LM320.REF.2" rid="LM320.REF.2">2</a>,<a class="bibr" href="#LM320.REF.3" rid="LM320.REF.3">3</a>] The clinical relevance of these findings in nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.</p><p>An observational study looked at outcomes of 2859 women who took an antidepressant during the 2 years prior to pregnancy. Compared to women who did not take an antidepressant during pregnancy, mothers who took an antidepressant during all 3 trimesters of pregnancy were 37% less likely to be breastfeeding upon hospital discharge. Mothers who took an antidepressant only during the third trimester were 75% less likely to be breastfeeding at discharge. Those who took an antidepressant only during the first and second trimesters did not have a reduced likelihood of breastfeeding at discharge.[<a class="bibr" href="#LM320.REF.4" rid="LM320.REF.4">4</a>] The antidepressants used by the mothers were not specified.</p><p>A retrospective cohort study of hospital electronic medical records from 2001 to 2008 compared women who had been dispensed an antidepressant during late gestation (n = 575) to those who had a psychiatric illness but did not receive an antidepressant (n = 1552) and mothers who did not have a psychiatric diagnosis (n = 30,535). Women who received an antidepressant were 37% less likely to be breastfeeding at discharge than women without a psychiatric diagnosis, but no less likely to be breastfeeding than untreated mothers with a psychiatric diagnosis.[<a class="bibr" href="#LM320.REF.5" rid="LM320.REF.5">5</a>] None of the mothers were taking amoxapine.</p><p>In a study of 80,882 Norwegian mother-infant pairs from 1999 to 2008, new postpartum antidepressant use was reported by 392 women and 201 reported that they continued antidepressants from pregnancy. Compared with the unexposed comparison group, late pregnancy antidepressant use was associated with a 7% reduced likelihood of breastfeeding initiation, but with no effect on breastfeeding duration or exclusivity. Compared with the unexposed comparison group, new or restarted antidepressant use was associated with a 63% reduced likelihood of predominant, and a 51% reduced likelihood of any breastfeeding at 6 months, as well as a 2.6-fold increased risk of abrupt breastfeeding discontinuation. Specific antidepressants were not mentioned.[<a class="bibr" href="#LM320.REF.6" rid="LM320.REF.6">6</a>]</p></div><div id="LM320.Alternate_Drugs_to_Consider"><h3>Alternate Drugs to Consider</h3><p><a href="/books/n/lactmed/LM314/?report=reader">Nortriptyline</a>, <a href="/books/n/lactmed/LM327/?report=reader">Paroxetine</a>, <a href="/books/n/lactmed/LM328/?report=reader">Sertraline</a></p></div><div id="LM320.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM320.REF.1">Gelenberg AJ. Amoxapine, a new antidepressant, appears in human milk. <span><span class="ref-journal">J Nerv Ment Dis. </span>1979;<span class="ref-vol">167</span>:635–6.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/573779" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 573779</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM320.REF.2">Gelenberg AJ, Cooper DS, Doller JC, et al. Galactorrhea and hyperprolactinemia associated with amoxapine therapy. Report of a case. <span><span class="ref-journal">JAMA. </span>1979;<span class="ref-vol">242</span>:1900–1.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/573343" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 573343</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM320.REF.3">Jaffe K, Zisook S. Galactorrhea in a patient treated with amoxapine. <span><span class="ref-journal">J Clin Psychiatry. </span>1978;<span class="ref-vol">39</span>:821.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/569147" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 569147</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM320.REF.4">Venkatesh KK, Castro VM, Perlis RH, et al. Impact of antidepressant treatment during pregnancy on obstetric outcomes among women previously treated for depression: An observational cohort study. <span><span class="ref-journal">J Perinatol. </span>2017;<span class="ref-vol">37</span>:1003–9.</span> [<a href="/pmc/articles/PMC10034861/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10034861</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28682318" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28682318</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="LM320.REF.5">Leggett C, Costi L, Morrison JL, et al. Antidepressant use in late gestation and breastfeeding rates at discharge from hospital. <span><span class="ref-journal">J Hum Lact. </span>2017;<span class="ref-vol">33</span>:701–9.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/28984528" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28984528</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="LM320.REF.6">Grzeskowiak LE, Saha MR, Nordeng H, et al. Perinatal antidepressant use and breastfeeding outcomes: Findings from the Norwegian Mother, Father and Child Cohort Study. <span><span class="ref-journal">Acta Obstet Gynecol Scand. </span>2022;<span class="ref-vol">101</span>:344–54.</span> [<a href="/pmc/articles/PMC9564556/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9564556</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35170756" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35170756</span></a>]</div></dd></dl></dl></div></div><div id="LM320.Substance_Identification"><h2 id="_LM320_Substance_Identification_">Substance Identification</h2><div id="LM320.Substance_Name"><h3>Substance Name</h3><p>Amoxapine</p></div><div id="LM320.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>14028-44-5</p></div><div id="LM320.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Antidepressive Agents</p><p>Serotonin Uptake Inhibitors</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501183_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">April 18, 2022</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Amoxapine. [Updated 2022 Apr 18].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM1052/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM13/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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