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Mycophenolate use while Breastfeeding

Drugs containing Mycophenolate: CellCept

Medically reviewed by Drugs.com. Last updated on Nov 28, 2020.

Mycophenolate Levels and Effects while Breastfeeding

Summary of Use during Lactation

No information is available on the excretion of mycophenolate into breastmilk. A few infants have reportedly been breastfed during mycophenolate therapy, with no adverse effects reported. Because little information is available on the use of mycophenolate during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

The National Transplantation Pregnancy Registry has collected information on 6 mothers (5 kidney and 2 heart transplants) who breastfed 7 infants while taking a mycophenolate product. The maximum time that any of the infants was breastfed was 14 months. None of the infants had any reported adverse reactions.[1]

In case series of 77 patients from the UK who received either a liver or cardiothoracic transplant, 9 took mycophenolate mofetil throughout pregnancy. Overall, 60% breastfed their infants, although the exact number who breastfed with mycophenolate or their outcomes were not reported.[2]

Another case series from the Transplant Pregnancy Registry International reported women who received heart transplants reported that 3 women breastfed their infants while taking mycophenolate. Durations of breastfeeding and infant outcomes were not reported.[3] It is possible that some of these women were the same as those in the case series above.

An Australian case series reported 3 women with heart transplants who had a total of 5 infants, all of whom were breastfed (extent not stated). Two of the women took mycophenolate mofetil postpartum, one in a dosage of 720 mg twice daily and the other woman in a dosage of 1 gram twice daily. No adverse infant effects were reported up to the times of hospital discharge.[4]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Azathioprine, Cyclosporine, Tacrolimus

References

1.
Constantinescu S, Pai A, Coscia LA, et al. Breast-feeding after transplantation. Best Pract Res Clin Obstet Gynaecol. 2014;28:1163–73. [PubMed: 25271063]
2.
Mohamed-Ahmed O, Nelson-Piercy C, Bramham K, et al. Pregnancy outcomes in liver and cardiothoracic transplant recipients: A UK national cohort study. PLoS One. 2014;9:e89151. [PMC free article: PMC3929648] [PubMed: 24586554]
3.
Punnoose LR, Coscia LA, Armenti DP, et al. Pregnancy outcomes in heart transplant recipients. J Heart Lung Transplant. 2020;39:473–80. [PubMed: 32201090]
4.
Boyle S, Sung-Him Mew T, Lust K, et al. Pregnancy following heart transplantation: A single centre case series and review of the literature. Heart Lung Circ. 2021;30:144–53. [PubMed: 33162367]

Substance Identification

Substance Name

Mycophenolate

CAS Registry Number

128794-94-5; 24280-93-1

Drug Class

Breast Feeding

Lactation

Immunosuppressive Agents

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Further information

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