Is Bevacizumab safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Bevacizumab. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A 33-year-old woman was treated with 14 intravitreal bevacizumab injections of 1.25 mg over a 20-month period. Five of these injections were given while she was breastfeeding (age of infant not stated). No mention was made of adverse effects in this infant, but she became pregnant again, received 3 additional injections, and delivered an infant who developed normally at 12 months of age.[ 8 ] A woman was given 3 intravitreal injections of bevacizumab for scar-associated choroidal neovascularization in her left eye. Her breastfed infant was 12 weeks old at the start of therapy. No mention was made of adverse effects in this infant.[ 6 ] Two women received intravitreal injections of bevacizumab 1.25 mg at 1- to 2-month intervals while breastfeeding. They breastfed their infants (extent not stated) for several months. No adverse effects in the infants were noted.[ 7 ] A woman who was 8 weeks postpartum received a single injection of intravitreal bevacizumab (dose not stated) intraoperatively and continued to breastfeed for an unspecified time. Her infant did well while followed up to 12 months of age.[ 9 ]
Effects on milk supply
A woman was given an intravitreal injection of bevacizumab (probably 1.25 mg) for scar-associated choroidal neovascularization in her left eye. After the injection, the VEGF level in breastmilk decreased from 13.3 to 8.6 mcg/L over a 2-week period after. After changing therapy to ranibizumab and administration of doses at 8 and 14 weeks after the start of therapy, no decrement in breastmilk VEGF was seen.[ 6 ]
Levels in milk
Maternal Levels. A woman was given an intravitreal injection of bevacizumab for scar-associated choroidal neovascularization in her left eye. Her breastfed infant was 12 weeks old at the start of therapy. The bevacizumab dose and interval were not stated in the published report, but the usual intravitreal dose is 1.25 mg. After the first injection, bevacizumab was detectable in the milk at a relatively constant 5 mcg/L over 42 days with a peak between 6 and 7 mcg/L at about 2 weeks following injection.[ 6 ] Two women received intravitreal injections of bevacizumab 1.25 mg at 1- to 2-month intervals while breastfeeding. Breastmilk samples were obtained one day before and one week after injections for 6 months in one and 16 months in the other woman. Bevacizumab was undetectable ( 3 mcg/L) in any of the samples.[ 7 ] 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.