Last update: Oct. 11, 2017

Glatiramer Acetate

Low Risk for breastfeeding


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

A synthetic polypeptide of 4 amino acids (l-alanine, l-glutamic, l-lysine and l-tyrosine), similar to myelin which is indicated in recurrences of multiple sclerosis (Ziemssen 2001).

Its high molecular weight makes it unlikely it will be excreted in breast milk and due to its protein nature it would be destroyed in the stomach of the infant, not absorbed, so its oral bioavailability is practically zero, except in premature babies and in the immediate neonatal period, where there may be greater intestinal permeability (2016 Almas, Cree 2013).

No problems have been observed in breastfeeding infants for periods ranging from 1 to 12 months whose mothers were taking glatiramer (Fragoso 2014, Hellwig 2012 and 2011, Fragoso 2010).

Glatiramer injected subcutaneously is hydrolyzed locally in amino acids and short peptides, so there are no appreciable levels of glatiramer in plasma. Severe side effects are unusual.

For some authors (Fragoso 2014) glatiramer would be the best multiple sclerosis disease-modifying drug to take during breastfeeding. One in 10 neurologists prescribe it during breastfeeding (Coyle 2004).

Alternatives

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.

Other names

Glatiramer Acetate in other languages or writings:

Group

Glatiramer Acetate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Glatiramer Acetate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. Baja - Poor %
Molecular weight 5.000 - 9.000 daltons

References

  1. Langer-Gould AM. Pregnancy and Family Planning in Multiple Sclerosis. Continuum (Minneap Minn). 2019 Jun;25(3):773-792. Abstract
  2. Almas S, Vance J, Baker T, Hale T. Management of Multiple Sclerosis in the Breastfeeding Mother. Mult Scler Int. 2016 Abstract Full text (link to original source) Full text (in our servers)
  3. Alroughani R, Altintas A, Al Jumah M, Sahraian M, Alsharoqi I, AlTahan A, Daif A, Dahdaleh M, Deleu D, Fernandez O, Grigoriadis N, Inshasi J, Karabudak R, Taha K, Totolyan N, Yamout BI, Zakaria M, Bohlega S. Pregnancy and the Use of Disease-Modifying Therapies in Patients with Multiple Sclerosis: Benefits versus Risks. Mult Scler Int. 2016 Abstract Full text (link to original source) Full text (in our servers)
  4. Fragoso YD. Glatiramer acetate to treat multiple sclerosis during pregnancy and lactation: a safety evaluation. Expert Opin Drug Saf. 2014 Abstract
  5. Cree BA. Update on reproductive safety of current and emerging disease-modifying therapies for multiple sclerosis. Mult Scler. 2013 Jun;19(7):835-43. Abstract Full text (link to original source) Full text (in our servers)
  6. Fragoso YD, Boggild M, Macias-Islas MA, Carra A, Schaerer KD, Aguayo A, de Almeida SM, Alvarenga MP, Alvarenga RM, Alves-Leon SV, Arruda WO, Brooks JB, Comini-Frota ER, Ferreira ML, Finkelsztejn A, Finkelsztejn JM, de Freitas LD, Gallina AS, da Gama PD, Georgetto S, Giacomo MC, Gomes S, et al. The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis. Clin Neurol Neurosurg. 2013 Abstract
  7. Hellwig K, Haghikia A, Rockhoff M, Gold R. Multiple sclerosis and pregnancy: experience from a nationwide database in Germany. Ther Adv Neurol Disord. 2012 Sep;5(5):247-53. Abstract Full text (link to original source) Full text (in our servers)
  8. Hellwig K, Gold R. Glatiramer acetate and interferon-beta throughout gestation and postpartum in women with multiple sclerosis. J Neurol. 2011 Abstract
  9. Fragoso YD, Finkelsztejn A, Kaimen-Maciel DR, Grzesiuk AK, Gallina AS, Lopes J, Morales NM, Alves-Leon SV, de Almeida SM. Long-term use of glatiramer acetate by 11 pregnant women with multiple sclerosis: a retrospective, multicentre case series. CNS Drugs. 2010 Abstract
  10. Coyle PK, Christie S, Fodor P, Fuchs K, Giesser B, Gutierrez A, Lynn J, Weinstock-Guttman B, Pardo L; Women Neurologists MS Initiative. Multiple sclerosis gender issues: clinical practices of women neurologists. Mult Scler. 2004 Abstract
  11. Ziemssen T, Neuhaus O, Hohlfeld R. Risk-benefit assessment of glatiramer acetate in multiple sclerosis. Drug Saf. 2001 Abstract

Total visits

6,625

Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write to us at elactancia.org@gmail.com

e-lactancia is a resource recommended by IHAN from Spain

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM