Is Filgrastim safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Filgrastim. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
Published information on the effects of filgrastim in breastmilk was not found as of the revision date. However, oral filgrastim 20 mcg daily for 5 days has been given to preterm infants with stage I necrotizing enterocolitis (NEC). Filgrastim appeared to halt progression to more severe stages of NEC in this small study.[ 6 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Granulocyte colony-stimulating factor (G-CSF) is a normal component of breastmilk. In the United States, the biosynthetic forms that are available for exogenous administration are filgrastim and pegfilgrastim. Other biosynthetic forms of G-CSF are available in other countries. Lenograstim is a glycosylated recombinant G-CSF whereas filgrastim is not glycosylated. Maternal Levels. A nursing mother who was 4 months postpartum was given the recombinant G-CSF product lenograstim in order to donate peripheral blood stem cells. She was given lenograstim subcutaneously in doses of 300 mcg on day 1,600 mcg daily on days 2 to 4 and 300 mcg daily on days 5 and 6 of therapy. G-CSF concentration in milk was less than 5 ng/L before therapy. G-CSF milk levels increased during therapy with levels of about 58 ng/L on day 4, 78 ng/L on day 5, and 85.7 ng/L on day 6. Sampling times were not stated.[ 2 ] The maximum amount in milk represents an infant dosage of about 0.013 mcg/kg which is 13% of an infant subcutaneous dose of exogenous G-CSF and 0.13% of the maternal weight-adjusted dosage. A woman received subcutaneous injections of filgrastim in the following doses: 600 mcg on day 1,300 mcg twice daily on days 2 to 5, and 300 mcg once on day 6 prior to harvesting white cells for donation. She was nursing her 25-day-old infant and milk G-CSF levels were measured once daily just before the first dose of the day. G-CSF was first detectable ( 10 ng/L) in whole milk 12 hours after the start of the regimen, had a peak milk concentration of 188 ng/L at 22 hours after the start of the regimen, and then after 43 hours, slowly declined until G-CSF was undetectable ( 10 ng/L) in breastmilk 70 hours after the last dose.[ 3 ] A patient received granulocyte colony stimulating factor (presumably filgrastim) for hematopoietic progenitor cell mobilization prior to transplantation. The exact dosage and regimen were not stated in the published abstract. The peak concentration of G-CSF in donor milk wa
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.