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I talked with an expectant mother who is currently taking Cinryze, C1 esterase inhibitor (human) for hereditary angioedema. It has just been FDA approved. She stated it has been used outside the US for some time. It is given by injection every 3 days. We were not able to find much information about taking it while breastfeeding. What are your thoughts? Thanks!
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Misty:
This is in my current MMM 2012.
C-1 esterase inhibitor is one of the serine proteinase inhibitors normally found in human blood. This endogenous C-1 inhibitor regulates the fibrinolytic system and also regulates the activation of the complement and intrinsic coagulation pathways. C-1 esterase inhibitor is used prophylactically in adolescents and adults with Hereditary Angioedema (HAE) to prevent recurrent episodes of angioedema.[1] In a study by Martinez-Saguer et al, no adverse effects were noted in 35 infants whose mothers were treated during pregnancy and lactation.[2] Due to the large molecular weight (105,000 kd) of C-1 esterase inhibitor, it is not expected to be found in large amounts in breastmilk. This constituent of plasma would also be unstable in the gastrointestinal tract of the infant.
Tom Hale Ph.D.
1.Pharmaceutical manufacturer prescribing information, 2011.
2.Martinez-Saguer I, Rusicke E, Aygoren-Pursun E, Heller C, Klingebiel T, and Kreuz W. Characterization of acute hereditary angioedema attacks during pregnancy and breast-feeding and their treatment with C1 inhibitor concentrate. Am J Obstet Gynecol 2010; 203:131. e1-7.
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