I am currently taking Tecfidera (dimethyl fumerate). I stopped breastfeeding my 17 month old to start the medication, but we are considering adding another little one to the family. I know I wouldn't be able to take the drug while pregnant, but I would like to know if any research is being done on whether women can breastfeed on this new drug. I would like to nurse as long as possible again, but I also want to keep my MS symptoms at bay. Thanks for anything you may have on this!
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Tecfidera and breastfeeding
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I'm also interested in this question. Currently nursing my 13month old with no immediate plans to wean (nursed my 1st child to 4). New lesions and clinical signs, so neurologist would like me on BG12. Am hesitant because I don't want to wean my son. Any studies would be great. I know it's been used for psoriasis in the past.
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Hi, thanks for your post.
There has not been any additional research into Tecfidera or other fumarates in terms of how they behave in milk. I am unable to locate any relevant animal research either. Theoretically, this drug would transfer into milk in significant quantities and should be used with caution. We give this drug an L4 safety rating (out of 5) ("Possibly hazardous").
Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519
-James Abbey, MD
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Hello! I am writing from Spain hoping to have a recent update on safety rating for taking tecfidera while breastfeeding. I realize that just in September the rating was L4. Does anyone have an update? If possible, could I have a fiber phone number or Skype address or regular phone number? I am not allowed to call 1-800 numbers from abroad and international calls are a bit expensive. I hope someone can get back to me about this important matter for I will have to start medicating the 20th of feb. Thank you!!
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There has not been any additional research published about the safety of this drug in breastfeeding women. We still consider it to be an L4. However, the half-life is so short that it may be possible to schedule your feedings around when you take the medication. If you can wait 3-4 hours after you take the pill before feeding the amount of drug that the baby is exposed to will be reduced by 80-90%. It is not necessary to discard your milk.
-James Abbey, MD
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Hi all.
I breastfed my son for about 6 months then started Tecfidera. I had no postpartum relapses and my MRI at about 1 year pp showed no changes from my previous MRI 3 years prior! It definitely helped that I was blessed with a super laid back baby that was a rockstar sleeper since day one. If that would not have been the case, I think I would have switched to formula sooner to allow my husband to help more.
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Last edited by cowolter; 04-26-2020, 10:16 AM.
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Hi Karolina,
I'm happy to report we have some unpublished data on dimethyl fumarate for you! We had two women taking the 240mg twice daily dose whose exposure in the milk was much lower than we expected. The Relative Infant Doses ranged from 0.007% to 0.019%. Knowing this, we now believe there is much less risk of infant exposure than previously thought. We have since reclassified the drug from an L4 to L2 (probably compatible) status in Hale's Medications and Mother's Milk.
Be on the lookout for this publication in the literature within the next year for more information!
Kaytlin Krutsch, PharmD, MBA, BCPS
Asst Professor, InfantRisk Center
TTU School of Medicine
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