Is Belimumab Safe in Breastfeeding
Question
I am a breastfeeding mother and i want to know if it is safe to use Belimumab? Is Belimumab safe for nursing mother and child? Does Belimumab extracts into breast milk? Does Belimumab has any long term or short term side effects on infants? Can Belimumab influence milk supply or can Belimumab decrease milk supply in lactating mothers?
Belimumab lactation summary
- DrLact safety Score for Belimumab is 3 out of 8 which is considered Low Risk as per our analyses.
- A safety Score of 3 indicates that usage of Belimumab may cause some minor side effects in breastfed baby.
- Our study of different scientific research indicates that Belimumab may cause moderate to no side effects in lactating mother.
- Most of scientific studies and research papers declaring usage of Belimumab low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
- While using Belimumab We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
- Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.
Answer by Dr. Ru: About Belimumab usage in lactation
IgG1λ human monoclonal antibody that is used for the treatment of lupus erythematosus. At latest update no published data on excretion into breast milk were found. Because a high molecular weight, excretion into breast milk makes is unlikely. Its protein-like composition would facilitate its destruction in the stomach, thus preventing the infant intestinal absorption, except in preterm and immediate neonatal period in which they may have an increased intestinal permeability. The European League Against Rheumatism (EULAR) does not recommend against breastfeeding on mothers treated with Belimumab, if no other therapeutic alternative is available.
Answer by DrLact: About Belimumab usage in lactation
No information is available on the clinical use of belimumab during breastfeeding. Because belimumab is a large protein molecule with a molecular weight of 147,000, the amount in milk is likely to be very low and absorption is unlikely because it is probably destroyed in the infant's gastrointestinal tract. If belimumab is required by the mother, it is not a reason to discontinue breastfeeding.[1] Until more data become available, belimumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. Belimumab is a human immunoglobulin G1 (IgG1) lambda antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[2][3] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%. Specific IgG subclasses decreased by different amounts, with IgG1 activity decreasing by about 37%.[4] None of the studies measured IgG activity.
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