Ankolysis Spondilytis/RA and Infliximab

[priyanka]

Hello ,

I have been a patient of Ankolysis Spondilytis/RA for the past 10 years.Past 7 years I have been taking Infliximab or Remicade.But for 1.5 years now I stopped it because I was pregnant and now breastfeeding.My condition in last 3 months has flared up and now I am considering again to start with the medication.

My quesation is can I breatfeed my 3.5 month old baby with Infliximab/Remicade.She is due to take her 4th month vaccination on 3rd Fed 2014.When I have waited so long so should I wait till her 4th month vaccination and take the medication and is it safe to breastfeed her immidiately after the medication.Can I breastfeed her less like twice a day or regularly as normal .

[admin]

Infliximab (Remicade) is a very large molecular weight antibody and is largely retained in the vascular system. It is highly unlikely that infliximab should enter breastmilk in significant quantities. Reported studies of infliximab use during breastfeeding have revealed that little to none enters breastmilk. Levels in milk are 1/200th of the levels in maternal serum. Furthermore, infliximab is not orally bioavailable. Any miniscule amounts ingested by the infant through breastmilk will undergo proteolysis in the infant's gastrointestinal tract, thereby having minimal impact on the immune system of the infant. Therefore, infliximab is probably compatible with breastfeeding.

Thus, I would suggest it is probably okay for you to take this medication while breastfeeding your infant normally. I would not suggest any waiting time because it has a very long half life of 8-9.5days.

Tassneem Abdel Karim MD
InfantRisk Cente