Summary of Use during Lactation

No information is available on the use of brolucizumab during breastfeeding. Brolucizumab inhibits vascular endothelial growth factor (VEGF). Because it is a large protein molecule with a molecular weight of 26,000 Da, the amount in milk is likely to be very low. Waiting for at least 2 weeks postpartum to resume therapy may minimize transfer to the infant.[1] It is also likely to be partially destroyed in the infant's gastrointestinal tract and absorption by the infant is probably minimal. The manufacturer states that breastfeeding is not recommended during treatment and for at least one month after the last dose. Since VEGF is present in human milk and is thought to help in maturation of the infant’s gastrointestinal tract, concern has been raised about the maternal use of VEGF inhibitors during breastfeeding. Note that the typical alternative to breastmilk is infant formula, which contains no VEGF.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

(Intravitreal) Bevacizumab, Ranibizumab

References

1.

Krysko KM, Dobson R, Alroughani R, et al. Family planning considerations in people with multiple sclerosis. Lancet Neurol. 2023;22:350–66. [PubMed: 36931808]

Substance Name

Brolucizumab

CAS Registry Number

1531589-13-5

Drug Class

Breast Feeding

Lactation

Milk, Human

Angiogenesis Inhibitors

Antibodies, Monoclonal