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Recommendations made
pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.


woomen

Is it allowed to take Infliximab during lactation?
Is it safe for a nursing mother and a child?

IgG1 monoclonal-antibody against tumor necrosis alpha factor (TNFα) which is used to treat autoimmune diseases such as Crohn's disease, Ulcerative Colitis, Rheumatoid Arthritis, Psoriatic Arthritis and Psoriasis. As a matter of fact, because of a very high molecular weight and high plasma protein-binding capacity, it is excreted into breastmilk in an undetectable amount (Mahadevan 2005, Vasiliauskas 2006, Stengel 2008, Kane 2009) or clinically non-significant (Ben-Horn 2011, Fritzsche 2012, Grosen 2014 , Matro 2015). Plasma levels of infants breastfed by mothers who were treated with Infliximab have resulted to be undetectable or very low (Vasiliauskas 2006, Kane 2009, Fritzsche 2012, Steenholdt 2012). Neither short nor long-term adverse effects on development, immunological response and/or infection rate, nor altered response to vaccination of infants whose mothers were taking Infliximab have been observed (Mahadevan 2005, Vasiliauskas 2006, Stengel 2008, Kane 2009, Tursi 2010, Puig 2010, Correia 2010 , Fritzsche 2012, Steenholdt 2012). Because it lacks of oral bioavailability, seems difficult any pass to the infant’s plasma through the ingested breastmilk, except on premature infants and immediate neonatal period, in which there may be an increased intestinal permeability. Numerous experts and scientific societies of Rheumatology, Gastroenterology and Dermatology consider it to be a very low risk drug, and therefore, compatible while breastfeeding (Mahadevan 2011, Nielsen 2014, Hyrich 2014, Mahadevan 2015, van der Houde 2015, Nguyen 2016, Flint 2016 , Gotestam 2016).

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woomen

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Types of risk

VERY LOW RISK
It is allowed while breastfeeding. It is not dangerous for a baby. It is moderately safe. more...

LOW RISK PROBABLE
Possible presence in breast milk is allowed. Follow the doctor's recommendation. more...

HIGH RISK PROBABLE
An unsafe drug, it is necessary to assess the risks while taking. Use safer analogs. more...

VERY HIGH RISK
It is not recommended. You need to stop breastfeeding or choose a safe analog. more...

Analogues

Trade Names

The main trade names in different countries containing in its composition Infliximab:

Scientific literature

The level of risk for breastfeeding is confirmed in these scientific publications:
  1. http://www.ncbi.nlm.nih.gov/pubmed/26888948
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  4. http://www.gastrojournal.org/article/S0016-5085(15)01773-4/pdf
  5. http://www.ncbi.nlm.nih.gov/pubmed/26750124
  6. http://rheumatology.oxfordjournals.org/content/55/9/1693.full.pdf
  7. http://www.ncbi.nlm.nih.gov/pubmed/26688268
  8. http://www.ncbi.nlm.nih.gov/pubmed/26129693
  9. http://www.ncbi.nlm.nih.gov/pubmed/26241432
  10. http://www.ncbi.nlm.nih.gov/pubmed/25829190
  11. http://www.reumatismo.org/index.php/reuma/article/download/reumatismo.2014.798/pdf_10
  12. http://www.ncbi.nlm.nih.gov/pubmed/25602023
  13. http://ecco-jcc.oxfordjournals.org/content/eccojc/9/2/107.full.pdf
  14. http://www.ncbi.nlm.nih.gov/pubmed/23897285
  15. http://www.ncbi.nlm.nih.gov/pubmed/24614280
  16. http://www.ncbi.nlm.nih.gov/pubmed/24090905
  17. http://ecco-jcc.oxfordjournals.org/content/eccojc/8/2/175.full.pdf
  18. http://www.ncbi.nlm.nih.gov/pubmed/24964946
  19. https://s3-eu-west-1.amazonaws.com/thejournalhub/10.15570/actaapa.2014.7/actaapa.2014.7.pdf
  20. http://www.ncbi.nlm.nih.gov/pubmed/24707132
  21. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974516/pdf/WJG-20-3495.pdf
  22. http://www.ncbi.nlm.nih.gov/pubmed/25200000
  23. http://onlinelibrary.wiley.com/doi/10.1111/apt.12949/epdf
  24. http://www.ncbi.nlm.nih.gov/pubmed/24352337
  25. http://www.ncbi.nlm.nih.gov/pubmed/24625373
  26. http://www.ncbi.nlm.nih.gov/pubmed/24528912
  27. http://www.ncbi.nlm.nih.gov/pubmed/23749699
  28. http://medwiekurozwoj.pl/articles/2013-1-10.pdf
  29. http://www.ncbi.nlm.nih.gov/pubmed/23474350
  30. http://www.dldjournalonline.com/article/S1590-8658(13)00050-9/pdf
  31. http://www.ncbi.nlm.nih.gov/pubmed/23200982
  32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913646/pdf/nihms-542223.pdf
  33. http://www.ncbi.nlm.nih.gov/pubmed/23752881
  34. http://www.ncbi.nlm.nih.gov/pubmed/24471298
  35. http://www.ncbi.nlm.nih.gov/pubmed/22387837
  36. http://pdf.medrang.co.kr/Kjg/059/Kjg059-02-05.pdf
  37. http://www.ncbi.nlm.nih.gov/pubmed/22018758
  38. http://www.ncbi.nlm.nih.gov/pubmed/22405174
  39. http://www.ncbi.nlm.nih.gov/pubmed/22690068
  40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369996/pdf/WJG-18-2600.pdf
  41. http://www.ncbi.nlm.nih.gov/pubmed/22221203
  42. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04967.x/epdf
  43. http://www.ncbi.nlm.nih.gov/pubmed/22858514
  44. http://www.ncbi.nlm.nih.gov/pubmed/22018758
  45. http://www.ncbi.nlm.nih.gov/pubmed/22387837
  46. http://www.ncbi.nlm.nih.gov/pubmed/21157441
  47. http://www.ncbi.nlm.nih.gov/pubmed/22115374
  48. http://ecco-jcc.oxfordjournals.org/content/eccojc/5/6/555.full.pdf
  49. http://www.ncbi.nlm.nih.gov/pubmed/19885906
  50. http://www.ncbi.nlm.nih.gov/pubmed/21122553
  51. http://ecco-jcc.oxfordjournals.org/content/eccojc/4/5/493.full.pdf
  52. http://www.ncbi.nlm.nih.gov/pubmed/20671559
  53. http://www.ncbi.nlm.nih.gov/pubmed/21063826
  54. http://www.ncbi.nlm.nih.gov/pubmed/19940453
  55. http://www.ncbi.nlm.nih.gov/pubmed/21122513
  56. http://www.ncbi.nlm.nih.gov/pubmed/21122513
  57. http://www.ncbi.nlm.nih.gov/pubmed/21122553
  58. http://www.ncbi.nlm.nih.gov/pubmed/21122490
  59. http://www.ncbi.nlm.nih.gov/pubmed/21172284
  60. http://download.journals.elsevierhealth.com/pdfs/journals/1873-9946/PIIS1873994609000269.pdf
  61. http://www.ncbi.nlm.nih.gov/pubmed/19452290
  62. http://www.ncbi.nlm.nih.gov/pubmed/19505214
  63. http://www.ncbi.nlm.nih.gov/pubmed/19142167
  64. http://www.ncbi.nlm.nih.gov/pubmed/19410016
  65. http://www.ncbi.nlm.nih.gov/pubmed/21172284
  66. http://www.ncbi.nlm.nih.gov/pubmed/18504282
  67. http://rheumatology.oxfordjournals.org/content/47/suppl_3/iii28.full.pdf
  68. http://www.ncbi.nlm.nih.gov/pubmed/18799245
  69. http://www.ncbi.nlm.nih.gov/pubmed/18494064
  70. http://www.ncbi.nlm.nih.gov/pubmed/17599074
  71. http://www.nature.com/nrrheum/journal/v3/n7/full/ncprheum0532.html
  72. http://www.ncbi.nlm.nih.gov/pubmed/18239407
  73. http://www.ncbi.nlm.nih.gov/pubmed/17661756
  74. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2007.03397.x/epdf
  75. http://www.ncbi.nlm.nih.gov/pubmed/16563889
  76. http://www.ncbi.nlm.nih.gov/pubmed/16712713
  77. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1526635/pdf/ar1957.pdf
  78. http://www.ncbi.nlm.nih.gov/pubmed/17045211
  79. http://www.ncbi.nlm.nih.gov/pubmed/16831611
  80. http://www.gastrojournal.org/article/S0016-5085(06)00865-1/pdf
  81. http://www.ncbi.nlm.nih.gov/pubmed/15771759

Comments  

+3 #1 Reviewer: goinwld, 55-64 on Treatment for 10 years or more (Patient) 2019-02-19 11:34
I have been taking Remicade every 8 weeks for 16 years. It has kept me in remission most of the time with a few flare ups. I also have ulcerative colitis and autoimmune hepatitis. The hepatitis is what led doctors to give me Remicade. My liver cannot handle a lot of drugs. I would recommend to anyone to give this drug a chance.

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