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Rho(D) Immune Globulin use while Breastfeeding

Drugs containing Rho(D) Immune Globulin: RhoGAM, Rhophylac, Anti-D (RHO) Immunoglobulin, WinRho SDF, RhoGAM Ultra-Filtered Plus, BayRHo-D Full Dose, Liberim D, Partobulin SDF, D-Gam Anti-D, BayRHo-D Mini-Dose, Show all 18 »Mini-Gamulin Rh, BayRHo-D, HypRho-D Mini-Dose, Gamulin Rh, MICRhoGAM, HyperRHO S/D Mini-Dose, MicRhoGAM Ultra-Filtered Plus, HyperRHO S/D Full Dose

Medically reviewed on Jun 17, 2018

Rho(D) Immune Globulin Levels and Effects while Breastfeeding

Summary of Use during Lactation

Rho(D) immune globulin is a immune globulin (IgG) rich in IgG antibodies against erythrocyte antigen Rho(D). IgG is a normal component of breastmilk. Rho(D) immune globulin is frequently used in nursing mothers and no adverse effects have been reported in breastfed infants. No special precautions are required.

Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[1][2] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%.[3] None of the studies measured IgG activity.

Drug Levels

Maternal Levels. Colostrum (3 days postpartum) and milk (7 days postpartum) samples from 2 mothers who were receiving intravenous immunoglobulin (IVIG) for the treatment of common variable immunodeficiency were studied. One mother was receiving 400 to 500 mg/kg of IVIG monthly and the other received 600 to 700 mg/kg of IVIG monthly. The time of the last dose before sample collection was not reported. Immune globulin G (IgG) concentrations were normal in the first mother's colostrum and milk and higher than normal in the colostrum of the second mother. IgM levels were normal in the colostrum and milk first mother and low in the second.[4]

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.

References

1. Koenig A, de Albuquerque Diniz EM, Barbosa SF et al. Immunologic factors in human milk: The effects of gestational age and pasteurization. J Hum Lact. 2005;21:439-43. PMID: 16280560

2. Adhisivam B, Vishnu Bhat B, Rao K et al. Effect of Holder pasteurization on macronutrients and immunoglobulin profile of pooled donor human milk. J Matern Fetal Neonatal Med. 2018;1-4. PMID: 29587541

3. Rodriguez-Camejo C, Puyol A, Fazio L et al. Antibody profile of colostrum and the effect of processing in human milk banks: Implications in immunoregulatory properties. J Hum Lact. 2018;34:137-47. PMID: 28586632

4. Palmeira P, Costa-Carvalho BT, Arslanian C et al. Transfer of antibodies across the placenta and in breast milk from mothers on intravenous immunoglobulin. Pediatr Allergy Immunol. 2009;20:528-35. PMID: 19220771

Rho(D) Immune Globulin Identification

Substance Name

Rho(D) Immune Globulin

CAS Registry Number

887269-77-4

Drug Class

Breast Feeding

Lactation

Antibodies

Immunoglobulins

Immunoglobulin G

Administrative Information

LactMed Record Number

844

Disclaimer

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Further information

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