Last update May 16, 2019
Very Low Risk
An antiretroviral integrase inhibitor.
Indicated in combination with two other antiretroviral drugs for the treatment of infection by the human immunodeficiency virus (HIV-1) and in the prophylaxis of vertical transmission (pregnancy/breastfeeding) (Puthanakit 2018, Westling 2012) and accidental post-exposure.
Oral administration in 2 daily doses.
Since the last update we have not found published data on its excretion in breastmilk.
Its pharmacokinetic data (moderately high molecular weight and percentage of protein binding, pKa acid and low lipid solubility) hinders transfer to breastmilk in significant quantities.
It is a well-tolerated drug with low frequency of serious side effects (MSD 2019, AEMPS2018, Clarke 2018, Ribera 2010), including in neonates, infants and children (Clarke 2018, Ripamonti 2016, Nachman 2015 and 2014).
It is used in nonpreterm newborns and from 3 kg of weight (Trahan 2019, MSD 2019, AEMPS 2018).
The WHO provides for neonatal use (Clarke 2018, WHO 2016, WHO 2014).
It is recommended after 2 to 4 weeks of life in the non-occupational post-exposure prophylaxis guidelines for HIV (CDC 2016, WHO 2014).
In preterm infants it has a longer elimination half-life, between 15 and 22 hours (Kreutzwiser 2017)
Since the last update, no problems have been reported in newborns and infants whose mothers were taking raltegravir.
We do not have alternatives for Raltegravir since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.
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