Last update: Aug. 7, 2019

Bevacizumab (intravenous infusion)

Low Risk for breastfeeding


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

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.


See below the information of these related products:

Alternatives

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.

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.

Group

Bevacizumab (intravenous infusion) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Bevacizumab (intravenous infusion) in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 149.000 daltons
VD 0,05 l/Kg
T1/2 480 hours

References

  1. Whittam DH, Tallantyre EC, Jolles S, Huda S, Moots RJ, Kim HJ, Robertson NP, Cree BAC, Jacob A. Rituximab in neurological disease: principles, evidence and practice. Pract Neurol. 2019 Feb;19(1):5-20. Abstract Full text (link to original source) Full text (in our servers)
  2. Matro R, Martin CF, Wolf D, Shah SA, Mahadevan U. Exposure Concentrations of Infants Breastfed by Women Receiving Biologic Therapies for Inflammatory Bowel Diseases and Effects of Breastfeeding on Infections and Development. Gastroenterology. 2018 Sep;155(3):696-704. Abstract Full text (link to original source) Full text (in our servers)
  3. Bragnes Y, Boshuizen R, de Vries A, Lexberg Å, Østensen M. Low level of Rituximab in human breast milk in a patient treated during lactation. Rheumatology (Oxford). 2017 Jun 1;56(6):1047-1048. Abstract
  4. BC Cancer. Bevacizumab. Drug Summary. 2016 Full text (in our servers)
  5. Götestam Skorpen C, Hoeltzenbein M, Tincani A, Fischer-Betz R, Elefant E, Chambers C, da Silva J, Nelson-Piercy C, Cetin I, Costedoat-Chalumeau N, Dolhain R, Förger F, Khamashta M, Ruiz-Irastorza G, Zink A, Vencovsky J, Cutolo M, Caeyers N, Zumbühl C, Østensen M. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016 May;75(5):795-810. Abstract Full text (link to original source) Full text (in our servers)
  6. Anderson PO. Monoclonal Antibodies. Breastfeed Med. 2016 Apr;11:100-1. Abstract
  7. EMA - Roche. Bevacizumab. Ficha técnica. 2015 Full text (in our servers)
  8. Witzel SJ. Lactation and the use of biologic immunosuppressive medications. Breastfeed Med. 2014 Dec;9(10):543-6. Abstract Full text (link to original source) Full text (in our servers)
  9. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  10. Pistilli B, Bellettini G, Giovannetti E, Codacci-Pisanelli G, Azim HA Jr, Benedetti G, Sarno MA, Peccatori FA. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: how should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013 May;39(3):207-11. Abstract
  11. Koren G, Carey N, Gagnon R, Maxwell C, Nulman I, Senikas V; Society of Obstetricians and Gynaecologists of Canada. Cancer chemotherapy and pregnancy. J Obstet Gynaecol Can. 2013 Mar;35(3):263-278. Abstract Full text (link to original source) Full text (in our servers)
  12. Fritzsche J, Pilch A, Mury D, Schaefer C, Weber-Schoendorfer C. Infliximab and adalimumab use during breastfeeding. J Clin Gastroenterol. 2012 Sep;46(8):718-9. Abstract

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