Is Sarilumab safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Sarilumab. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A woman with rheumatoid arthritis refractory to etanercept took sarilumab 200 mg every two weeks during pregnancy until 37 weeks of gestation. She was also taking prednisolone 10 mg and tacrolimus 3 mg daily. She delivered a healthy infant at 38 weeks of gestation and breastfed her infant. Prednisolone was continued postpartum; tacrolimus was restarted at 7 days postpartum and sarilumab was restarted at 28 days postpartum. The mother continued to breastfeed until 6 months postpartum. The infant was vaccinated with multiple live vaccines after reaching six months old, including the Bacille-Calmette-Guerin vaccine, with no adverse effects.[ 6 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. A lactating woman was receiving subcutaneous sarilumab 150 mg every 2 weeks for rheumatoid arthritis. After 5 doses of the drug, she donated 6 milk samples over a 28-day period. The peak concentration of about 160 mcg/L occurred on day 3 after the dose. By day 7, the milk sarilumab concentration decreased to about 110 mcg/L; on day 14, the milk concentration was about 75 mcg/L. The drug was undetectable in mill at 28 days after the dose.[ 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.