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Everolimus is a macrolide, a derivative of sirolimus, with immunosuppressive properties. It is used in the prevention of graft rejection in heart, kidney or liver transplant patients and in the treatment of certain cancers. It frequently causes potentially serious adverse effects: infections, anemia, anemia, thrombopenia, leukolymphopenia, anorexia, irritability, weight loss, increased liver enzymes... (Everolimius 2013). Oral administration once or twice daily.
Its pharmacokinetic data (large volume of distribution and high molecular weight) make it unlikely to pass into breast milk in clinically significant quantities. There are published data on its excretion in colostrum, which is undetectable or negligible (Kociszewska 2017, Fiocchi 2016).
Its low oral bioavailability makes it difficult to pass into infant plasma from ingested breast milk, except in premature infants and immediate neonatal period where there may be higher intestinal permeability.
Expert authors consider breastfeeding compatible with the mother taking this drug, especially in the first days after delivery (Kociszewska 2017).
Pending further published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in case of prematurity.