Is Imatinib Safe in Breastfeeding

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

• DrLact safety Score for Imatinib is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Imatinib may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Imatinib may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using Imatinib .
• It is recommended to evaluate the advantage of not breastfeeding while using Imatinib Vs not using Imatinib And continue breastfeeding.
• While using Imatinib Its must to monitor 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.

Inhibitor of tyrosine kinase that is used for treatment of Leukemia and some types of cancer. Excretion intro breast milk is very low, with no problems reported among breastfed infants from treated mothers. Concentration in the mother's milk decreases to one half after 9 hours from the last dose which is a property that could be taken advantage of to minimize the dose transfer to the infant if stopping breastfeeding is not desired. If continuation of safely breastfeeding is desired without assuming high risk for potentially severe side-effects, elimination of total burden of drug should be kept. For this to happen, breastfeeding should be stopped for 10 half-lives (T ½). It means wait 16 days after the last dose before resuming breastfeeding. Meanwhile, frequent pump-and-dump is recommended for maintenance of milk production.

Limited information indicates that maternal doses of imatinib up to 400 mg daily produce low levels of the drug and its active metabolite in milk. Although a few breastfed infants apparently experienced no adverse effects during maternal use of imatinib, no long-term data are available. Until more data are available, imatinib should be used only with careful monitoring during breastfeeding. The manufacturer and some authors recommend that breastfeeding be discontinued during imatinib therapy and for 1 month after therapy.[1][2]

A woman receiving oral imatinib 400 mg daily for chronic myeloid leukemia breastfed her infant. No adverse effects were noted in the infant during the first 2 months of nursing.[3] One woman with chronic myelogenous leukemia received imatinib 400 mg daily throughout pregnancy and during breastfeeding (extent not stated) for nearly 6 months postpartum. Her infant reportedly grew and developed normally.[9] A woman with chronic myeloid leukemia received imatinib 400 mg daily starting at week 8 of pregnancy and continuing throughout 8 months of breastfeeding (extent not stated). The infant was healthy, but an atrial septal defect was repaired at 30 months of age. It was thought to be unrelated to imatinib therapy.[10]