Tenofovir Alafenamide Fumarate for Hepatitis B

[Lactation Clinic]

We have a breastfeeding mother on Tenofovir Alafenamide Fumarate 25 mg (1 tab once daily) for hepatitis B. Please suggest about the breastfeeding management. Thank you very much.

[alicia]

In a full term, healthy baby it is probably ok. This medication is an L5 to highlight the contraindication of breastfeeding when the mother is known to be infected with HIV, this medication is not an L5 based on its risk to the infant in breast milk. The Centers for Disease Control and Prevention recommend that HIV-1 infected mothers do not breastfeed their infants to avoid postnatal transmission of HIV-1. Infant Monitoring: Insomnia, vomiting, poor weight gain. With some exceptions, breastfeeding is not recommended in mothers who have HIV. May have pediatrician monitor liver enzymes.
Alicia Nelson RN
Infant Risk Center

[Lactation Clinic]

Dear Alicia Nelson,
Thank you very much.

[llmitch]

Hello! I understand that this medication is an L-5 when the mother is infected with HIV. Has this drug been assigned a risk category when it is used for hepatitis B in a non HIV mother with a premature infant born at 33 weeks three weeks ago.
Thanks so much!

[kaytlin]

Hi llmitch,

Thank you for bringing this to our attention. I'll re-evaluate the lactation risk category as we develop the next edition of Hale's Medications and Mothers' Milk. For now, it is safe to assume we will classify it as at least an L3 outside of HIV indications.

Dr. Krutsch

[llmitch]

Thank you, Dr. Krutsch.