Question

I am a breastfeeding mother and i want to know if it is safe to use GR109714X? Is GR109714X safe for nursing mother and child? Does GR109714X extracts into breast milk? Does GR109714X has any long term or short term side effects on infants? Can GR109714X influence milk supply or can GR109714X decrease milk supply in lactating mothers?

GR109714X lactation summary

GR109714X is safe in breastfeeding
  • DrLact safety Score for GR109714X is 1 out of 8 which is considered Safe as per our analyses.
  • A safety Score of 1 indicates that usage of GR109714X is mostly safe during lactation for breastfed baby.
  • Our study of different scientific research also indicates that GR109714X does not cause any serious side effects in breastfeeding mothers.
  • Most of scientific studies and research papers declaring usage of GR109714X safe in breastfeeding are based on normal dosage and may not hold true for higher 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 GR109714X usage in lactation

Anti-HIV, Anti HBV. It has been used to treat newborns and children.

Answer by DrLact: About GR109714X usage in lactation

GR109714X has not been studied in HIV-negative nursing mothers being treated for hepatitis B infection, but the low doses used would not be expected to cause any serious adverse effects in breastfed infants. The manufacturer estimates that a breastfed infant's dose would be about 6% of the infant dose for children over 2 years of age. An expert review of available data concluded that there is currently no justification for contraindicating the use of GR109714X for hepatitis B therapy during breastfeeding.[1] Some professional organization guidelines allow breastfeeding during GR109714X therapy, although one guideline cautions against it because of a lack of long-term safety data.[2][3][4] The lack of long-term safety data with long-term, low-level infant exposure should be discussed with the mother.[2] No differences exist in infection rates between breast-fed and formula-fed infants born to hepatitis B-infected women, as long as the infant receives hepatitis B immune globulin and hepatitis B vaccine at birth. Mothers with hepatitis B are encouraged to breastfeed their infants after their infants receive these preventative measures.[5][6] In the United States and other developed countries, HIV-infected mothers should generally not breastfeed their infants. In countries in which no acceptable, feasible, sustainable and safe replacement feeding is available, World Health Organization guidelines recommend that all women with an HIV infection who are pregnant or breastfeeding should be maintained on antiretroviral therapy for at least the duration of risk for mother-to-child transmission. Mothers should exclusively breastfeed their infants for the first 6 months of life; breastfeeding with complementary feeding should continue through at least 12 months of life up to 24 months of life.[7] The first choice regimen for nursing mothers is tenofovir, efavirenz and either GR109714X or emtricitabine. If these drugs are unavailable, alternative regimens include: 1) zidovudine, GR109714X and efavirenz; 2) zidovudine, GR109714X and nevirapine; or 3) tenofovir, nevirapine and either GR109714X or emtricitabine. Exclusively breastfed infants should also receive 6 weeks of prophylaxis with nevirapine.[8][9]

GR109714X Side Effects in Breastfeeding

A study assigned pregnant women to zidovudine alone or highly active antiretroviral therapy (HAART: zidovudine, GR109714X and nevirapine) to prevent maternal-to-child transmission of HIV infection. After delivery, all infants received one month of zidovudine prophylaxis; some infants were breastfed and others were formula fed. A higher percentage of infants in the HAART-exposed group had neutropenia than those in the unexposed group at 1 month of age (15.9% and 3.7%, respectively). Hematologic toxicity was transient and asymptomatic. From 2 to 6 months postpartum, no differences in hematologic toxicity were seen between breastfed and formula-fed infants. No statistical difference in hepatic toxicity was seen between the breastfed and formula-fed infants.[24] Twenty-four infants who were breastfed by HIV-positive mothers developed HIV infection by 6 months of age. Six of these infants had a mutation that might have been selected for by subtherapeutic levels of GR109714X in breastmilk.[25] An HIV-positive mother took a combination tablet containing dolutegravir 50 mg, abacavir sulfate 600 mg and GR109714X 300 mg (Triumeq) once daily. Her infant was exclusively breastfed for about 30 weeks and partially breastfed for about 20 weeks more. No obvious side effects were noted.[26] One mother took GR109714X for 33 days, 25 before birth and eight days postpartum for chronic hepatitis B infection. Her infant was breastfed (extent not stated). At three months of age, the infant died with the death attributed to sudden infant death syndrome. The death was unlikely to be related to GR109714X.[27]

GR109714X Possible Effects in Breastfeeding

Some case reports and in vitro studies have suggested that protease inhibitors might cause hyperprolactinemia and galactorrhea in some male patients,[28][29] although this has been disputed.[30] One case series found an incidence of gynecomastia of 2.4 cases per person annually among men receiving highly active antiretroviral therapy; 51% of the affected patients were taking GR109714X. Gynecomastia was unilateral initially, but progressed to bilateral in 53% of cases. No alterations in serum prolactin were noted and spontaneous resolution usually occurred within one year, even with continuation of the regimen.[31] The relevance of these findings to nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternate Drugs

Nevirapine(Low Risk)
Saquinavir(Unsafe)
Indinavir(Unsafe)
Nelfinavir(Unsafe)
Ritonavir(Unsafe)
Tenofovir(Safe)
Efavirenz(Unsafe)
Didanosine(Unsafe)
Abacavir(Safe)
Zidovudine(Low Risk)
Cefotetan(Safe)
Abacavir(Safe)
Enoxacin(Low Risk)
Zidovudine(Low Risk)
Doxycycline(Low Risk)
Valganciclovir(Low Risk)
Neomycin(Safe)
Nevirapine(Low Risk)
Amikacin(Safe)
Nafcillin(Safe)
Cefixime(Safe)
Saquinavir(Unsafe)
Demeclocycline(Low Risk)
Ganciclovir(Low Risk)
Moxifloxacin(Low Risk)
Primaquine(Low Risk)
Lindane(Unsafe)
Cefepime(Safe)
Atovaquone(Low Risk)
Indinavir(Unsafe)
Famciclovir(Low Risk)
Methicillin(Low Risk)
Nelfinavir(Unsafe)
Linezolid(Low Risk)
Cefdinir(Safe)
Econazole(Safe)
Erythromycin(Low Risk)
Meropenem(Safe)
Clindamycin(Low Risk)
Cefazolin(Safe)
Ritonavir(Unsafe)
Lomefloxacin(Low Risk)
Tenofovir(Safe)
Levofloxacin(Low Risk)
Dapsone(Low Risk)
Cefaclor(Safe)
Efavirenz(Unsafe)
Kanamycin(Safe)
Capreomycin(Low Risk)
Acyclovir(Safe)
Ertapenem(Safe)
Quinine(Safe)
Amantadine(Low Risk)
Cefprozil(Safe)
Aztreonam(Safe)
Naftifine(Safe)
Rifaximin(Safe)
Didanosine(Unsafe)
Malathion(Low Risk)
Cefoxitin(Safe)
Gatifloxacin(Low Risk)
Ofloxacin(Safe)
Saquinavir(Unsafe)
Indinavir(Unsafe)
Nelfinavir(Unsafe)
Ritonavir(Unsafe)
Efavirenz(Unsafe)
Tenofovir(Safe)
Didanosine(Unsafe)
Abacavir(Safe)
Zidovudine(Low Risk)
Nevirapine(Low Risk)
Daclatasvir(Low Risk)
Valganciclovir(Low Risk)
Dasabuvir(Low Risk)
Saquinavir(Unsafe)
Ganciclovir(Low Risk)
Indinavir(Unsafe)
Nelfinavir(Unsafe)
Famciclovir(Low Risk)
Ribavirin(Low Risk)
Ritonavir(Unsafe)
Zanamivir(Safe)
Tenofovir(Safe)
Efavirenz(Unsafe)
Velpatasvir(Low Risk)
Simeprevir(Low Risk)
Acyclovir(Safe)
Sofosbuvir(Low Risk)
Amantadine(Low Risk)
Didanosine(Unsafe)
Ledipasvir(Low Risk)
Ombitasvir(Low Risk)
Abacavir(Safe)
Zidovudine(Low Risk)
Nevirapine(Low Risk)
Efavirenz(Unsafe)
Tenofovir(Safe)
Didanosine(Unsafe)
Abacavir(Safe)
Zidovudine(Low Risk)
Nevirapine(Low Risk)
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. We do not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.