Last update Feb. 19, 2021
It is a recombinant humanized IgG1 anti-immunoglobulin E (IgE) monoclonal antibody.
It is an immunoglobulin G (IgG) of huge molecular weight that binds with great affinity to IgE, blocking it, forming IgG-IgE complexes of even larger size and molecular weight.
It is indicated in the prophylaxis of severe persistent asthma and in the treatment of chronic urticaria.
Its use is authorized in children from 6 years of age (EMA 2016, Pediamecum 2015).
Subcutaneous administration every 2 to 4 weeks.
It is excreted in breast milk in clinically insignificant amounts (Saito 2020) and no problems have been observed in infants whose mothers have taken it (Losappio 2020, López 2019, Ensina 2017, González 2017).
Its high molecular weight makes its excretion in milk very unlikely.
Its low oral bioavailability would hinder its transfer to infant plasma from ingested breast milk since, due to its protein nature, it degrades in the gastrointestinal tract, and is not absorbed, except in premature infants and the immediate neonatal period, when there may be greater intestinal permeability.
Several medical societies, experts authors and expert consensus, consider the use of this medication to be safe or very probably safe during breastfeeding (Hale, Lactmed, Türk 2020, Middleton 2020, Whittam 2019, Matro 2018, Anderson 2018 y 2016, Witzel 2014, Pistilli 2013).
Other monoclonal antibodies of similar structure and molecular weight (adalimumab, certolizumab, infliximab) are known not to be excreted in breast milk in clinically significant amounts and do not harm the infant, and are therefore considered compatible with breastfeeding.
We do not have alternatives for Omalizumab.
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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Thank you for helping to protect and promote breastfeeding.
e-lactancia is a resource recommended by Asociación Española de Bancos de Leche Humana of Spain
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM