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Psoriasis drugs Otezla and Stelara compatible with breastfeeding?

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  • #1

    Psoriasis drugs Otezla and Stelara compatible with breastfeeding?

    Hello,

    I've been nursing my son for 5 months now. I've had psoriasis for many years, and I've not been using much medication since trying to get pregnant a few years ago. It's gotten pretty bad on my scalp since having my son in late June, and I'm ready to take the next step in treating it - which is either a biologic like Humira or Stelara, or a new pill called Otezla. I like the idea of Stelara, which is taken via an injection only a few times a year, but it's an immunosupressant, which makes me nervous. Otezla is not even a year old yet but is a pill - very convenient.

    Can you tell me if either drug is compatible with breastfeeding? I'd like to continue to nurse my son while undergoing treatment for psoriasis, but if I have to stop, I will.

    Thanks.
    NHMom
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  • #2
    I have just found out that the molecular weight of Otezla is 460.5. I found this:

    Otezla (apremilast) is a phosphodiesterase 4 (PDE4) inhibitor. Apremilast is known chemically as N-[2-[(1S)-1-(3-ethoxy-4-methoxyphenyl)-2-(methylsulfonyl)ethyl]-2,3-dihydro-1,3-dioxo-1H-isoindol-4-yl]acetamide. Its empirical formula is C22H24N2O7S and the molecular weight is 460.5.


    Info I found on Stelara says this:

    STELARA? is comprised of 1326 amino acids and has an estimated molecular mass that ranges from 148,079 to 149,690 Daltons.

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    • #3
      Hi, thanks for your post. Sorry about the delay, we had to look into Otezla. Unfortunately, there is no published data on Otezla or any of the other PDE4 inhibitors with regard to breastfeeding safety. However, its chemical properties allow us to predict that a significant amount of the drug will likely appear in the milk. Whether that amount will produce noticeable or important side effects in the baby is not clear. Use at your own risk.

      Here is what we have to say about Humira and Stelara:
      http://mommymeds.com/frequently-asked-questions/monoclonal-antibodies

      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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