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Ranibizumab use while Breastfeeding

Drugs containing Ranibizumab: Lucentis

Ranibizumab Levels and Effects while Breastfeeding

Summary of Use during Lactation

Because ranibizumab is a large protein molecule with a molecular weight of 48,000, the amount in milk is likely to be very low and absorption is unlikely because it is probably destroyed in the infant's gastrointestinal tract. One infant was breastfed, apparently without noticeable harm, following maternal intravitreal ranibizumab injections. Vascular endothelial growth factor (VEGF) levels in breastmilk were not changed following the injection. Because the breast and neonatal intestine have VEGF receptors, some authors recommend use of intravitreal ranibizumab over bevacizumab, which does appear to depress milk VEGF levels.[1]

Drug Levels

Maternal Levels. A woman was given 3 intravitreal injections of bevacizumab for scar-associated choroidal neovascularization in her left eye. Vascular endothelial growth factor (VEGF) was measured in serum and breastmilk. After the intravitreal injection of bevacizumab, the VEGF level in breastmilk decreased from 13.3 to 8.6 mcg/L over a 2-week period. After changing therapy to ranibizumab therapy, no decrement in breastmilk VEGF was seen during the 42 days following injection.[1]

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

Effects in Breastfed Infants

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

Effects on Lactation and Breastmilk

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

Alternate Drugs to Consider

(Intravitreal) Bevacizumab

References

1. Ehlken C, Martin G, Stahl A, Agostini HT. Reduction of vascular endothelial growth factor a in human breast milk after intravitreal injection of bevacizumab but not ranibizumab. Arch Ophthalmol. 2012;130:1226-7. PMID: 22965611

Ranibizumab Identification

Substance Name

Ranibizumab

CAS Registry Number

347396-82-1

Drug Class

Antibodies, Monoclonal

Angiogenesis Inhibitors

Administrative Information

LactMed Record Number

1012

Last Revision Date

20160707

Disclaimer

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