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A selective and reversible inhibitor of Janus kinases 1 and 2.
It is used alone or associated with methotrexate in moderate to severe rheumatoid arthritis.
Oral administration once a day.
Used experimentally in the treatment of the COVID-19 coronavirus (Favalli 2020).
Since the last update we have not found published data on its excretion in breastmilk.
Its pharmacokinetic data makes it difficult to accurately predict its possible excretion in breastmilk, because although its high volume of distribution would hinder it, its molecular weight and low fixation to plasma proteins would facilitate it.
Its frequent side effects are mild to moderate infections and thrombocytopenia.
Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in cases of prematurity.
It is known from pharmacokinetics that after 5 elimination half-lives (T½) 96.9 % of the drug is eliminated from the body and from 7 T½ the plasma concentrations of the drug in the body are negligible. In general, a period of five to seven half-lives can be considered a safe waiting period before resuming breastfeeding.
Taking the longest published T½ (12.5 h) as a reference, these 5 - 7 T½ would correspond to 2,5 -3,5 days. Meanwhile, express and discard milk from the breast regularly to maintain production.
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