Last update Aug. 18, 2021
Chimeric murine/human monoclonal antibody of the recombinant DNA IgG1K with specific immunosuppressive effect.
Indicated for the prevention of kidney transplant rejection in adult and pediatric patients from one year of age.
Intravenous administration in two doses, one in the 2 hours before transplant and another 4 days after transplant
At the date of the last update, the authors did not find any published data on its excretion in breast milk.
Its very high molecular weight (>100,000 Da) makes it very unlikely to pass into milk in a significant amount, since molecules of more than 800 - 1,000 Da do not pass into breast milk (Hale, Almas 2016, Anderson 2016).
Null or negligible passage into breast milk of other similar monoclonal antibodies, such as Adalimumab, Certolizumab, Golimumab, Infliximab, Ipilimumab, Natalizumab, Rituximab and Ustekinumab (Bar-Gil 2021, LaHue 2020, Ciplea 2020, Saito 2020, 2019 and 2018, Krysko 2019, Whittam 2019, Klenske 2019, Matro 2018, Anderson 2018, Bragnes 2017, Witzel 2014, Ross 2014, Fritzsche 2012).
Due to its protein nature, it is inactivated in the gastrointestinal tract, not being absorbed (practically nil oral bioavailability), which hinders or prevents the passage into plasma of the infant from ingested breast milk (Lactmed, Rademaker 2018, Bragnes 2017, Götestam 2016 , Mervic 2014, Witzel 2014, Butler 2014), except in premature infants and during the immediate neonatal period, in which there may be greater intestinal absorption (Sammaritano 2020).
No problems have been detected in infants whose mothers received other similar monoclonal antibodies, such as belimumab, bevacizumab, infliximab, ituximab, rituximab, tocilizumab, or ustekinumab (Bar-Gil 2021, LaHue 2020, Saito 2020, 2019 and 2018, Klenske 2019, Mugheddu 2019, Krysko 2019, Matro 2018, Bragnes 2017, Hyrich 2014, Danve 2014).
Various medical societies, expert authors and expert consensus consider the use of this medication during breastfeeding compatible or probably compatible (Whittam 2019, Matro 2018, Anderson 2018 y 2016, Witzel 2014, Pistilli 2013).
Given the strong evidence that exists on the benefits of breastfeeding for the development of babies and the health of mothers, it is convenient to evaluate the risk-benefit of any maternal treatment, individually advising each mother who wishes to continue breastfeeding (Koren 2013).
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.
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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2012 of United States of America
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM