Recommendations made
pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.
Is it allowed to take Infliximab during lactation? |
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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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Would you like to ask something else about Infliximab ? |
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:- http://www.ncbi.nlm.nih.gov/pubmed/26888948
- http://ard.bmj.com/content/early/2016/02/17/annrheumdis-2015-208840.full.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/26688268
- http://www.gastrojournal.org/article/S0016-5085(15)01773-4/pdf
- http://www.ncbi.nlm.nih.gov/pubmed/26750124
- http://rheumatology.oxfordjournals.org/content/55/9/1693.full.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/26688268
- http://www.ncbi.nlm.nih.gov/pubmed/26129693
- http://www.ncbi.nlm.nih.gov/pubmed/26241432
- http://www.ncbi.nlm.nih.gov/pubmed/25829190
- http://www.reumatismo.org/index.php/reuma/article/download/reumatismo.2014.798/pdf_10
- http://www.ncbi.nlm.nih.gov/pubmed/25602023
- http://ecco-jcc.oxfordjournals.org/content/eccojc/9/2/107.full.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/23897285
- http://www.ncbi.nlm.nih.gov/pubmed/24614280
- http://www.ncbi.nlm.nih.gov/pubmed/24090905
- http://ecco-jcc.oxfordjournals.org/content/eccojc/8/2/175.full.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/24964946
- https://s3-eu-west-1.amazonaws.com/thejournalhub/10.15570/actaapa.2014.7/actaapa.2014.7.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/24707132
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3974516/pdf/WJG-20-3495.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/25200000
- http://onlinelibrary.wiley.com/doi/10.1111/apt.12949/epdf
- http://www.ncbi.nlm.nih.gov/pubmed/24352337
- http://www.ncbi.nlm.nih.gov/pubmed/24625373
- http://www.ncbi.nlm.nih.gov/pubmed/24528912
- http://www.ncbi.nlm.nih.gov/pubmed/23749699
- http://medwiekurozwoj.pl/articles/2013-1-10.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/23474350
- http://www.dldjournalonline.com/article/S1590-8658(13)00050-9/pdf
- http://www.ncbi.nlm.nih.gov/pubmed/23200982
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913646/pdf/nihms-542223.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/23752881
- http://www.ncbi.nlm.nih.gov/pubmed/24471298
- http://www.ncbi.nlm.nih.gov/pubmed/22387837
- http://pdf.medrang.co.kr/Kjg/059/Kjg059-02-05.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/22018758
- http://www.ncbi.nlm.nih.gov/pubmed/22405174
- http://www.ncbi.nlm.nih.gov/pubmed/22690068
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3369996/pdf/WJG-18-2600.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/22221203
- http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04967.x/epdf
- http://www.ncbi.nlm.nih.gov/pubmed/22858514
- http://www.ncbi.nlm.nih.gov/pubmed/22018758
- http://www.ncbi.nlm.nih.gov/pubmed/22387837
- http://www.ncbi.nlm.nih.gov/pubmed/21157441
- http://www.ncbi.nlm.nih.gov/pubmed/22115374
- http://ecco-jcc.oxfordjournals.org/content/eccojc/5/6/555.full.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/19885906
- http://www.ncbi.nlm.nih.gov/pubmed/21122553
- http://ecco-jcc.oxfordjournals.org/content/eccojc/4/5/493.full.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/20671559
- http://www.ncbi.nlm.nih.gov/pubmed/21063826
- http://www.ncbi.nlm.nih.gov/pubmed/19940453
- http://www.ncbi.nlm.nih.gov/pubmed/21122513
- http://www.ncbi.nlm.nih.gov/pubmed/21122513
- http://www.ncbi.nlm.nih.gov/pubmed/21122553
- http://www.ncbi.nlm.nih.gov/pubmed/21122490
- http://www.ncbi.nlm.nih.gov/pubmed/21172284
- http://download.journals.elsevierhealth.com/pdfs/journals/1873-9946/PIIS1873994609000269.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/19452290
- http://www.ncbi.nlm.nih.gov/pubmed/19505214
- http://www.ncbi.nlm.nih.gov/pubmed/19142167
- http://www.ncbi.nlm.nih.gov/pubmed/19410016
- http://www.ncbi.nlm.nih.gov/pubmed/21172284
- http://www.ncbi.nlm.nih.gov/pubmed/18504282
- http://rheumatology.oxfordjournals.org/content/47/suppl_3/iii28.full.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/18799245
- http://www.ncbi.nlm.nih.gov/pubmed/18494064
- http://www.ncbi.nlm.nih.gov/pubmed/17599074
- http://www.nature.com/nrrheum/journal/v3/n7/full/ncprheum0532.html
- http://www.ncbi.nlm.nih.gov/pubmed/18239407
- http://www.ncbi.nlm.nih.gov/pubmed/17661756
- http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2007.03397.x/epdf
- http://www.ncbi.nlm.nih.gov/pubmed/16563889
- http://www.ncbi.nlm.nih.gov/pubmed/16712713
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1526635/pdf/ar1957.pdf
- http://www.ncbi.nlm.nih.gov/pubmed/17045211
- http://www.ncbi.nlm.nih.gov/pubmed/16831611
- http://www.gastrojournal.org/article/S0016-5085(06)00865-1/pdf
- http://www.ncbi.nlm.nih.gov/pubmed/15771759
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