フマル酸 ; フマル酸ジメチル

Anti-inflammatory and immunomodulatory used in the treatment of psoriasis and in relapsing forms of multiple sclerosis. Topical and oral administration every 12 hours.

Its pharmacokinetic data, wide volume of distribution and short half-life, explain ^{(Almas 2016)} the negligible passage to breast milk observed. ^{(Ciplea 2020)}

Dimethyl fumarate is not found in plasma as it is immediately converted to monomethyl fumarate, an active drug with a half-life of about 1 hour. ^{(Almas 2016)}

Possible side effects are rare and generally not serious (gastrointestinal and leukopenia), without presenting immunosuppressive effects or a higher frequency of infections.^{(AEMPS 2015, EMA 2017)}

Various medical societies and/or expert consensus consider the use of this medication during breastfeeding possibly safe ^{(Hale, Alroughani 2016, Briggs 2015)}, although others differ. ^{(Langer 2019}).

Exposure can be minimized by 90% by waiting 3 hours to breastfeed again after taking the drug.

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives may be preferable ^{(Langer 2019, Cree 2013)}, especially during the neonatal period and in the case of prematurity.

Given the strong evidence that exists on the benefits of breastfeeding for the development of babies and the health of mothers, it is convenient to evaluate the risk-benefit of any maternal treatment, including chemotherapy, individually advising each mother who wishes to continue with breastfeeding. ^{(Koren 2013)}

See below the information of this related product:

• Maternal Multiple Sclerosis (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)