Is Abatacept safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Abatacept. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A woman with rheumatoid arthritis resumed weekly doses of abatacept 125 mg subcutaneously 2 days after delivery. Her infant was exclusively breastfed up until 12 months of age. Her infant had no adverse effects and developed normally during this time. She also received routine childhood vaccinations at 3 months of age as well as rotavirus and BCG vaccination at 6 months of age. No infections or adverse immune reactions were seen following the vaccinations.[ 5 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. A woman with rheumatoid arthritis resumed weekly doses of abatacept 125 mg subcutaneously 2 days after delivery. Maternal serum and breastmilk samples were obtained after the 9th and 10th doses. Peak abatacept concentrations in milk occurred at about 3 days after each dose at 256 mcg/L. Prior to the next dose, the trough concentration was 170 mcg/L. The authors estimated the daily infant dose to be between 25 and 38 mcg/kg, which translates into a weight-adjusted percent of maternal dosage of 1 to 1.5% (median 1.3%).[ 5 ] Two lactating women who were receiving abatacept for rheumatoid arthritis donated milk samples for analysis. The first, who was receiving a subcutaneous dose of 125 mg once weekly, had a peak milk level of about 200 mcg/L at 3 days after the dose and a level of about 100 mcg/L at 7 days after the dose. The second, who was receiving an intravenous dose of 500 mg every 2 weeks, had a peak milk level of about 100 mcg/L at 3 days after the dose and a level of about 50 mcg/L at 7 days after the dose.[ 6 ] Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.