Is Remdesivir safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Remdesivir. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
The manufacturer reports that 11 breastfed infants were exposed to remdesevir in breastmilk from pharmacovigilance reports. The reports do not indicate adverse effects on breastfed infants from exposure to remdesivir and its metabolite through breastmilk.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Two days after delivery, a woman was diagnosed with a SARS-CoV-2 infection. She was given 200 mg of remdesivir on the first day of therapy, then 100 mg daily for 4 more days. Although not stated, all doses are presumed to have been given intravenously. On day 5 of therapy, milk was collected just before the dose and 1, 3, 6, and 24 hours after the last dose. Remdesevir and its metabolite GS-441524 were measured in milk. The concentration of remdesivir in milk was 1.29 mcg/L one hour before administration on day 5, but undetectable ( 0.5 mcg/L) in the other samples. The concentration of the active metabolite GS-441524 in the milk samples were 13.5 mcg/L before the fifth dose, 285 mcg/L at 3 hours after the dose and 64.3 mcg/L at 24 hours after the dose. The authors estimated the relative infant doses of remdesevir and GS-441524 in breastmilk as 0.007% and 1.6%, respectively. The half-life of GS-441524 in milk was estimated to be 9.3 hours.[ 5 ] Four women with COVID-19 who received remdesivir provided 17 milk samples for analysis of remdesivir and its active metabolite GS-441524. All of the milk samples had unquantifiable ( 100 mcg/L) concentrations of remdesevir. Eleven of the samples contained unquantifiable ( 100 mcg/L) concentrations of GS-441524. The highest concentration of the metabolite in the remaining 6 samples from one woman was 168 mcg/L. Using this worst-case value, the infant dose would be 25.2 mcg/kg daily, which would be a relative infant dose of 5%.[ 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.