Peginterferon Beta use while Breastfeeding
Medically reviewed by Drugs.com. Last updated on May 1, 2021.
Peginterferon Beta Levels and Effects while Breastfeeding
Summary of Use during Lactation
Although no information is available on peginterferon beta-1a in breastmilk, the levels of conventional interferon beta-1a in breastmilk are minuscule. In addition, because interferon is poorly absorbed orally, it is not likely to reach the bloodstream of the infant. Many women have breastfed while taking conventional interferon beta-1a and a few with peginterferon beta-1a with no adverse infant effects reported. The Multiple Sclerosis Centre of Excellence on Reproduction and Child Health considers interferon beta to be "moderately safe" to use during breastfeeding, and a French consensus group of neurologists concluded that interferon beta can be used during breastfeeding. No special precautions appear to be required during breastfeeding while using interferon beta.
Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous interferon-gamma by an average about 10%.
Maternal Levels. Six breastfeeding women with multiple sclerosis began peginterferon beta-1a 125 mcg as a single injection. Patients collected a baseline breastmilk sample prior to treatment initiation and daily breastmilk samples on days 1–14. The peginterferon beta-1a concentration in breastmilk at baseline was below detectable levels. The highest breastmilk concentration recorded was 126.2 ng/L. The geometric mean peak concentration was 48.9 ng/L and the median time to the peak was 4 days. Half of the patients had no detectable milk levels (<15 ng/L) at 7 days after the dose. Mean breastmilk concentrations were 56 ng/L, 56.9 ng/L, 42.8 ng/L, and 27.4 ng/L on days 1, 5, 10 and 14, respectively.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Six women had been receiving interferon beta-1a (Avonex, Biogen) 30 mcg intramuscularly once weekly for multiple sclerosis for months to years. None of the mothers noticed any adverse effects in their breastfed infants.
A woman received interferon beta-1b (Betaferon, BayerHealthCare; dosage unspecified) for multiple sclerosis throughout pregnancy. She continued the drug while she exclusively breastfed her infant. At 5 months of age, the infant was monitored regularly by a physician and was developing well with no abnormalities.
One mother received interferon beta-1a for multiple sclerosis during pregnancy and postpartum. All of their infants were exclusively breastfed for 6 months and no noticeable problems were reported in any of them.
In data collected from 4 countries, 17 women received interferon and 41 women received glatiramer during pregnancy and postpartum for treatment of multiple sclerosis. Of these, 63% breastfed (extent not stated) their infants for a mean of 8.8 months. No mention was made of adverse reactions in breastfed infants.
Thirty-nine women with multiple sclerosis who were treated with interferon beta-1a during breastfeeding were followed by the German Multiple Sclerosis and Pregnancy Registry. During breastfeeding, the drug was administered every other day (n = 8), 3 times a week (n = 15), or once a week (n = 12). In addition, one woman receive peginterferon beta-1a every 2 weeks, and in 3 additional women, the frequency was not known. One woman received both interferon beta-1a every other day and glatiramer daily. Most infants were also exposed during pregnancy. Infants were breastfed for an average of 9.2 months (range 1.6 to 28.5 months) during interferon therapy. Infants were followed for 1 year and most developed normally; the percentages of infants with developmental delay, courses of antibiotics and hospitalizations did not differ from the reference German population. No conditions attributable to interferon beta-1a were found.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
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Houtchens M, Manieri MC, Mahlanza T, et al. Interim analysis of peginterferon beta-1a in the breast milk of lactating patients with multiple sclerosis. Neurology 2020;94. WOS:000536058005277.
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Fragoso YD, Boggild M, Macias-Islas MA, et al. The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis. Clin Neurol Neurosurg. 2013;115:154–9. [PubMed: 22633835]
Ciplea AI, Langer-Gould A, Stahl A, et al. Safety of potential breast milk exposure to IFN-beta or glatiramer acetate: One-year infant outcomes. Neurol Neuroimmunol Neuroinflamm. 2020;7:e757. [PMC free article: PMC7251509] [PubMed: 32434802]
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