Question

I am a breastfeeding mother and i want to know if it is safe to use Evolocumab? Is Evolocumab safe for nursing mother and child? Does Evolocumab extracts into breast milk? Does Evolocumab has any long term or short term side effects on infants? Can Evolocumab influence milk supply or can Evolocumab decrease milk supply in lactating mothers?

Answer by DrLact: About Evolocumab usage in lactation

No information is available on the clinical use of evolocumab during breastfeeding. Because evolocumab is a large protein molecule with a molecular weight of 144,000, 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. Until more data become available, evolocumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. Evolocumab is a human immunoglobulin G2 (IgG2) antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[1][2] 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 IgG2 activity decreasing by about 50%.[3] None of the studies measured IgG activity.
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