Last update Aug. 30, 2018
Very Low Risk
An IgG1 monoclonal antibody against the tumor necrosis factor alpha (TNFα) used in autoimmune diseases, rheumatoid arthritis, psoriatic arthritis, psoriasis and ankylosing spondylitis.
Subcutaneous administration once or twice a week for 12 to 24 weeks.
Possibly due to its high molecular weight and its high plasma protein binding, it is excreted in breastmilk in clinically insignificant amounts (Butler 2014, Berthelsen 2010, Keeling 2010, Murashima 2009, Østensen 2007, 2006 and 2004).
The plasma levels of infants breastfed by mothers who are administered etanercept are undetectable or very low (Berthelsen 2010, Murashima 2009).
No short-term or long-term developmental, infection or immunological problems or problems with vaccination have been observed in infants whose mothers take etanercept (Dall'ara 2016, Calligaro 2015, Butler 2014, Keeling 2010).
Its zero oral bioavailability would hinder transfer from breastmilk to the infant’s plasma (Amin 2018, Grunewald 2015, Mervic 2014, Butler 2014, Hyrich 2013, Bae 2012, Keeling 2010), except in premature infants and the immediate neonatal period, when there can be greater intestinal permeability.
Numerous experts and scientific associations of rheumatology and dermatology consider its use very low risk and, therefore, compatible during breastfeeding (Amin 2018, Flint 2016, Götestam 2016, Dall'ara 2016, Grunewald 2015, Nielsen 2014, Mervic 2014, Butler 2014, Hyrich 2013, Habal 2012, Berthelsen 2010, Keeling 2010, Fischer 2010, Murashima 2009).
We do not have alternatives for Etanercept since it is relatively safe.
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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