Last update: Aug. 7, 2019
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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Human-like monoclonal antibody (IgG1 immunoglobulin) produced by DNA recombinant technology.
Used in the form of an intravenous infusion in the treatment of various metastatic or advanced cancers.
Since the last update we have not found published data on its excretion in breastmilk.
Its very high molecular weight makes its excretion in breastmilk very unlikely.
The zero or negligible transfer to breastmilk of other similar monoclonal antibodies such as adalimumab, certolizumab, golimumab, infliximab, natalizumab, rituximab and ustekinumab (Matro 2018, Bragnes 2017, Witzel 2014, Fritzsche 2012) has been demonstrated.
Due to its protein nature, it is inactivated in the gastrointestinal tract, and is not absorbed, (it has virtually no oral bioavailability), which hinders or prevents its transfer from breastmilk to infant plasma (Whittam 2019, Bragnes 2017, Götestam 2016, Witzel 2014, Butler 2014) except in premature babies and the immediate neonatal period, when there may be greater intestinal permeability.
Expert authors consider the use of monoclonal antibodies to be safe or very probably safe during breastfeeding (Whittam 2019, Matro 2018, Anderson 2016, Witzel 2014, Pistilli 2013).
Given the strong existing evidence regarding the benefits of breastfeeding for the development of babies and the health of mothers, it is advisable to evaluate the risk-benefit of any maternal treatment, including chemotherapy, individually advising each mother who wishes to continue with breastfeeding (Koren 2013).
Intravitreal administration is used in macular degeneration due to choroidal neovascularization.
We do not have alternatives for Bevacizumab (intravenous infusion).
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.
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.
e-lactancia is a resource recommended by Instituto de Salud Infantil, Grecia-Institute of Child's Health in Greece
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM