Last update Aug. 23, 2021

Aflibercept (Ophtalmic use)

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Recombinant fusion protein that suppresses neovascularization and decreases vascular permeability.
Indicated for intravitreal injection in forms of macular degeneration and edema and myopic choroidal neovascularization.

After intravitreal administration, plasma concentrations at 1-3 days are low (0 to 0.05 micrograms/mL) and undetectable at 2 weeks. That concentration is between 50 and 500 times lower than necessary to have any systemic effect. In addition, it binds to vascular endothelial growth factor, forming an inert compound that, like other proteins, is degraded by protein catabolism. It does not accumulate after repeated doses every 4 weeks (EMA 2017).

Its very high molecular weight explains the negligible passage to breast milk observed (Juncal 2020), since molecules of more than 800 - 1,000 Da do not pass into breast milk (Hale).

Due to its protein nature, it is inactivated in the gastrointestinal tract, not being absorbed (practically zero oral bioavailability), which makes it difficult or impossible to pass into the infant’s plasma from ingested breast milk, except in premature infants and during the immediate neonatal period in infants, where there may be increased intestinal permeability.

Alternatives

  • Ranibizumab ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Aflibercept (Ophtalmic use) in other languages or writings:

Group

Aflibercept (Ophtalmic use) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Aflibercept (Ophtalmic use) in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 115.000 daltons
VD 0.09 l/Kg
120 -144 hours
Theoretical Dose 0.0016 mg/Kg/d
Relative Dose 0.49 %

References

  1. Juncal VR, Paracha Q, Bamakrid M, Francisconi CLM, Farah J, Kherani A, Muni RH. Ranibizumab and Aflibercept Levels in Breast Milk after Intravitreal Injection. Ophthalmology. 2020 Feb;127(2):278-280. Abstract
  2. EMA. Aflibercept. Ficha técnica. 2017 Full text (in our servers)
  3. EMA. Aflibercept. Drug Summary. 2017 Full text (in our servers)

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