Is Anakinra safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Anakinra. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A woman was receiving anakinra 100 mg daily for adult-onset Still's disease during pregnancy and lactation. Her breastfed (extent not stated) infant gained wight and appeared to have normal psychomotor development during an unspecified follow-up period.[ 6 ] Among a cohort of 18 women with term pregnancies treated with anakinra for cryopyrin-associated periodic syndromes during pregnancy, 3 of the women breastfed their infants (extent not stated) for periods of 1 month, 3 months and 1 year. No adverse neonatal outcomes were reported.[ 7 ] In an international multicenter study of mothers exposed to interleukin-1 receptor antagonists, 10 babies were breastfed (extent not stated) by mothers receiving anakinra for up to 10 months. No infections or developmental abnormalities were reported.[ 8 ] Three of the cases had been reported previously in reference[ 7 ]. Of 5 women who took anakinra during pregnancy, two breastfed their infants while continuing to receive anakinra 100 mg daily. No serious infections were reported and development was normal.[ 9 ] A woman was treated with anakinra 100 mg subcutaneously once daily and oral colchicine 1 mg twice daily during pregnancy and postpartum for familial Mediterranean fever while she breastfed her infant (extent not stated). At 9 months of age, the infant s development was within normal range. The routine vaccination schedule for the baby was being performed on time and there was no history of infection in the infant.[ 10 ] A woman with juvenile idiopathic arthritis was treated until 19 weeks of pregnancy with anakinra 100 mg daily by subcutaneous injection. It was discontinued for the duration of the pregnancy and then restarted 2 weeks after delivery while she partially breastfed her infant. No adverse reactions were reported.[ 11 ] A woman with recurrent pericarditis was treated with subcutaneous anakinra 100 mg once weekly beginning in the fifth month of pregnancy and continuing postpartum. She also took colchicine 0.5 mg
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. The concentration of IL-1Ra in colostrum in 88 normal mothers was 672 ng/L, which was higher than the plasma concentration. Mature milk levels were lower than those in colostrum. Samples collected over a period of 2 to 6 months postpartum indicated that mothers continued to excrete IL-1Ra during this time.[ 4 ] Mothers with acute mastitis had slightly higher average levels of IL-1Ra than levels after recovery, but the median values were the same. The levels found in these mothers were the same as those of control mothers.[ 5 ] 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.