Denosumab

[hurdeni]

I have a suspected giant cell tumor reoccurrence in my distal tibia. Suggested treatment will likely be denosumab (xgeva), 120 mg every 4 weeks. My son just turned 1 and he is in the 95+ percentile for age and weight, he breastfeeds fairly frequently but also eats solids very well too. I believe the high molecular size makes it unlikely to transfer into milk and that most would be absorbed in his gastrointestinal track? Do you have any additional information? Thank you so much for your time!

[admin]

hurdeni:

the manufacturer strongly recommends using this in breastfeeding moms, but we think the risk is relatively small. But a 1 year of age, you'll have to weight the relatively small risk of this drug with the moderate benefit of continued breastfeeding.

I think the risk is probably low,

Tom Hale Ph.D.

[hurdeni]

Thank you for your response. I noticed in a new prescribing guide that the manufacturer says to weight the risk and aren’t strongly recommending against it like in previous guides, is there a reason for this? [url]https://www.pi.amgen.com/~/media/amgen/repositorysites/pi-amgen-com/xgeva/xgeva_pi.pdf[/url]

[admin]

Well, we simply don't know how much gets into human milk. New studies show it 1-2% maybe, and most of this is probably metabolized like any other protein in milk.

Tom

[hurdeni]

Thank you for your time! I appreciate it.