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CIMZIA while breastfeeding

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  • CIMZIA while breastfeeding

    I would like you to inform me of any up-to-date information on taking cimzia while breastfeeding. I am a patient with ankylosing spondylitis and the baby is 14 months old. Ideally I would like to stop the breastfeeding but it is very difficult and necessarily in the phase I am in so much pain I have to take the treatment.
    thanks in’s advance

  • #2
    Hi Anky--you're in luck! Cimzia is one of the few drugs we have data on and of your monoclonal antibody options, it is our favorite. It was designed specifically to prevent the transfer of drug during pregnancy (and lactation). Transfer into milk is extremely low.

    Find the results at this link if you'd like to know more: [url]https://pubmed.ncbi.nlm.nih.gov/28814432/[/url]

    Kaytlin Krutsch, PharmD

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    • #3
      Thank you very much for your response!
      So,this very low transfer, are we sure that is safe for the child?
      Is there any case to affect His immune system?
      Also, what about the vaccinations of the child? Is there any danger through them, from CIMZIA, even in so low levels?
      for the end, could you please tell me in numbers and no percentages how much drug goes to the child From each dose?
      His digestive system, absorbs it all or eliminates it?
      thank you and sorry for all these questions

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      • #4
        I suggest calling the InfantRisk Center Hotline to talk things through with one of our nurses. They do an excellent job of answering questions and helping with the surrounding anxiety of the decision.

        I'm happy to share my opinion on your questions though, you've got some great questions.

        So,this very low transfer, are we sure that is safe for the child?: In our field (or medicine in general), we seldom have enough data to say we're "sure" about anything. This is why we call it the "art" of medicine. However, I'm very comfortable saying I don't expect harm to your child.

        Is there any case to affect His immune system?: Again, I think this is very unlikely (rationale below)

        Also, what about the vaccinations of the child?: Unless you had Cimzia during pregnancy (in which case I would need to do more research), I would not worry about withholding live vaccinations (these are the riskier ones).

        Is there any danger through them, from CIMZIA, even in so low levels?: Not in this scenario.

        for the end, could you please tell me in numbers and no percentages how much drug goes to the child From each dose?: This question is tricky, and the short answer is that it depends on many things. Most of all, it depends on how much milk he is getting. We don't have a great way to calculate this for older babies, especially after they start eating solids--it is just too variable between kids and between days. The best I can tell you is that for a similar drug that transfers 100 times more than Cimzia, I calculated how much milk a baby would need to start getting to a therapeutic dose. It would take baby eating over 500 LITERS of human milk per kilogram every day to start getting close to a therapeutic drug level. So you can see that the big picture is that there is practically no way for your baby to get that much drug from your milk. And again, this was for a drug that transfers to a much higher degree.

        His digestive system, absorbs it all or eliminates it?: His stomach should destroy about half of any Certolizumab pegol (Cimzia) that makes it in to milk. Only about 5% of what is left might be absorbed. This drug doesn't work well when you take it by mouth, which is why it comes in an injection for you.

        Hope this helps,
        Kaytlin Krutsch, PharmD

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        • #5
          Thank you very very much!!! Really!
          Best regards,
          Anastasia

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