Last update July 14, 2022
Very Low Risk
Human monoclonal antibody IgG1 that binds to interleukins 12 and 23. It is used to treat severe plaque psoriasis, psoriatic arthritis, and Crohn’s disease and ulcerative colitis. Intravenous and subcutaneous administration every 12 weeks.
Its pharmacokinetic data (very high molecular weight and wide volume of distribution) explain the negligible passage to breast milk observed. (Saito 2022, Bar-Gil 2021, Klenske 2019, Matro 2018)
No clinical problems or a higher rate of infections and no problems with routine vaccinations have been observed in infants of mothers receiving this drug. (Saito 2022, Bar-Gil 2021, Klenske 2019, Mugheddu 2019, Matro 2018)
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, 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. (Lactmed, Hale, Bar-Gil 2021, Laube 2021, Gisbert 2020, Sammaritano 2020, Lamb 2019, Picardo 2019, Mahadevan 2019, Amin 2018, Götestam 2016, McConnell 2016)
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