Last update July 17, 2023

Brincidofovir

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Brincidofovir is a cidofovir prodrug consisting of cidofovir conjugated to a lipid molecule, that is converted intracellularly to cidofovir. It is used in the treatment of smallpox and its utility against adenoviruses, herpesviruses, CMV, monkeypox virus, and Ebola virus is under investigation. Oral administration once or twice a week.

Since the last update we have not found published data on its excretion in breastmilk.

Its pharmacokinetic data (FDA 2021, Alvárez 2020) (very high percentage of protein binding, moderately high molecular weight and very wide volume of distribution) make it highly unlikely that significant quantities will pass into breast milk, although its high lipophilicity could increase it.

Its very low oral bioavailability (FDA 2021) makes it difficult for it to pass to the infant plasma from ingested breast milk, except in premature infants and in the immediate neonatal period in which there may be greater intestinal permeability.

Its side effects are rare and mild. (FDA 2021)

t has been used in young infants. (Chan 2021, London 2020)

It  is considered a potential human carcinogen. (FDA 2021)


See below the information of these related products:

  • Cetrimide ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)
  • Cidofovir ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)
  • Mpox, maternal infection with monkeypox virus ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)

Alternatives

  • Tecovirimat (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)

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

Brincidofovir in other languages or writings:

Group

Brincidofovir belongs to this group or family:

Tradenames

Main tradenames from several countries containing Brincidofovir in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 13.4 -16.8 %
Molecular weight 562 daltons
Protein Binding > 99 %
VD 17.6 l/Kg
pKa 1.32 -
Tmax 2 - 3 hours
19.3 (metabolit: 113) hours

References

  1. Rizk JG, Lippi G, Henry BM, Forthal DN, Rizk Y. Prevention and Treatment of Monkeypox. Drugs. 2022 Jun 28. Consulted on July 13, 2022 Abstract Full text (link to original source)
  2. Gaeta F, De Caro F, Franci G, Pagliano P, Vajro P, Mandato C. Monkeypox Infection 2022: An Updated Narrative Review Focusing on the Neonatal and Pediatric Population. Children (Basel). 2022 Nov 26;9(12). pii: 1832. Abstract Full text (link to original source)
  3. FDA. Brincidofovir (Tembexa). Drug Summary. 2021 Full text (in our servers)
  4. Chan SY, Prockop SE, Boulad F, Papanicolaou GA, Lee YJ. Rapid Virologic Response to Brincidofovir in Children with Disseminated Adenovirus Infection. Infect Chemother. 2021 Sep;53(3):572-577. Abstract
  5. Londeree J, Winterberg PD, Garro R, George RP, Shin S, Liverman R, Serluco A, Romero R, Yildirim I. Brincidofovir for the treatment of human adenovirus infection in pediatric solid organ transplant recipients: A case series. Pediatr Transplant. 2020 Nov;24(7):e13769. Abstract
  6. Alvarez-Cardona JJ, Whited LK, Chemaly RF. Brincidofovir: understanding its unique profile and potential role against adenovirus and other viral infections. Future Microbiol. 2020 Apr;15:389-400. Abstract

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