Question

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

Answer by DrLact: About Sarilumab usage in lactation

No information is available on the clinical use of sarilumab during breastfeeding. Because sarilumab is a large protein molecule with a molecular weight of about 150,000, 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 sarilumab is required by the mother, it is not a reason to discontinue breastfeeding.[1] Until more data become available, sarilumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. Sarilumab is a human immunoglobulin G1 (IgG1) antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G in mature milk by 60 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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