Adalimumab use while Breastfeeding
Drugs containing Adalimumab: Humira
Adalimumab Levels and Effects while Breastfeeding
Summary of Use during Lactation
Limited information indicates that maternal adalimumab injections produce low levels in milk and do not adversely affect the nursing infant. Because little is excreted into breastmilk and is not likely to be absorbed, some experts feel that the drug is proably safe during nursing.[1][2][3][4] However, until more data become available, an alternative drug may be preferred, especially while nursing a newborn or preterm infant.
Drug Levels
Maternal Levels. One woman received a single 40 mg of adalimumab subcutaneously at 4 weeks postpartum. Milk samples were obtained every 2 days for 8 days. A peak milk adalimumab level of 31 mcg/L was detected on day 6 after injection. Milk levels on days 5 and 8 were about 10 mcg/L.[5]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
One woman with Crohn's disease received adalimumab 40 mg subcutaneously every week during pregnancy and breastfeeding (extent not stated). Her infant demonstrated normal growth and development at 6 months of age.[6] The authors reported a brief follow-up stating that the woman also breastfed her second infant during adalimumab therapy with no adverse consequences.[1]
Another woman with Crohn's disease received adalimumab 40 mg subcutaneously every 2 weeks during pregnancy and breastfeeding (extent not stated). Her infant demonstrated normal growth and development at 6 months of age.[7]
Possible Effects on Lactation
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
References
1. Mahadevan U. Pregnancy, fertility and therapies for IBD. Gastroenterol Hepatol. 2006;2:234-6.
2. Skomsvoll JF, Wallenius M, Koksvik HS et al. Drug Insight: anti-tumor necrosis factor therapy for inflammatory arthropathies during reproduction, pregnancy and lactation . Nature Clin Pract Rheumatol. 2007;3:156-64. PMID: 17334338
3. Ostensen M. Management of early aggressive rheumatoid arthritis during pregnancy and lactation. Expert Opin Pharmacother. 2009;10:1469-79. PMID: 19505214
4. van der Woude CJ, Kolacek S, Dotan I et al. European evidenced-based consensus on reproduction in inflammatory bowel disease. J Crohn's Colitis. 2010;4:493-510. PMID: 21122553
5. Ben-Horin S, Yavzori M, Katz L et al. Adalimumab level in breast milk of a nursing mother. Clin Gastroenterol Hepatol. 2010;8:475-6. PMID: 20005982
6. Vesga L, Terdiman JP, Mahadevan U. Adalimumab use in pregnancy. Gut. 2005;54:890. PMID: 15888806
7. Mishkin DS, Van Deinse W, Becker JM, Farraye FA. Successful use of adalimumab (Humira) for Crohn's disease in pregnancy. Inflamm Bowel Dis. 2006;12:827-8. PMID: 16917239
Adalimumab Identification
Substance Name
CAS Registry Number
331731-18-1
Drug Class
- Antibodies, Monoclonal
- Antirheumatic Agents
- Dermatologic Agents
- Gastrointestinal Agents
Administrative Information
LactMed Record Number
513
Information from the National Library of Medicine's LactMed Database.
Last Revision Date
2011-01-04
Disclaimer
Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
See Also...
- Adalimumab use during Pregnancy
- Adalimumab Consumer Information
- Breastfeeding Support Group
- Safe Medications during Breastfeeding
- Medicine use while Breastfeeding
- Medicine use during Pregnancy
Disclaimer: This information is not intended as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. Use of this website signifies your agreement to the Terms of Use and Online Privacy Policy.
