Drug Class: Recombinant human erythropoietins
Epoetin Beta Levels and Effects while Breastfeeding
Summary of Use during Lactation
Methoxy polyethylene glycol-epoetin beta is a synthetic form of erythropoietin that slowly releases the active drug, epoetin beta (recombinant human erythropoietin). Erythropoietin is a normal component of human milk. The excretion of exogenous methoxy polyethylene glycol-epoetin beta in breastmilk has not been studied; although the similar drug epoetin alfa has been studied and is considered to be acceptable during breastfeeding. Since no information is available on its use during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
A study on Holder pasteurization of breastmilk found that the erythropoietin concentration in breastmilk dropped from about 1.9 international units/L before pasteurization to about 0.5 international units/L after pasteurization.[1]
Drug Levels
Maternal Levels. Relevant published information on exogenous administration of epoetin beta was not found as of the revision date. However, breastmilk normally contains erythropoietin. Erythropoietin concentrations in human milk are in the range of approximately 4 to 5 units/L in the first 1 to 2 months postpartum and increase to 20 to 40 units/L by the third month and to 100 to 150 units/L by 12 months.[2]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Enhancement of gastrointestinal tract maturation has been proposed as a function of erythropoietin in breastmilk.[2,3]
Effects on Lactation and Breastmilk
In small studies, epoetin alfa administration decreased serum prolactin in patients with amyotrophic lateral sclerosis,[4] but had no effect in normal subjects or in patients with renal failure undergoing chronic ambulatory peritoneal dialysis.[5,6] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Alternate Drugs to Consider
Epoetin Alfa
References
- 1.
-
Untalan PB, Keeney SE, Palkowetz KH, et al. Heat susceptibility of interleukin-10 and other cytokines in donor human milk. Breastfeed Med. 2009;4:137–44. [PubMed: 19366315]
- 2.
-
Miller M, Iliff P, Stoltzfus RJ, et al. Breastmilk erythropoietin and mother-to-child HIV transmission through breastmilk. Lancet. 2002;360:1246–8. [PubMed: 12401271]
- 3.
-
Semba RD, Juul SE. Erythropoietin in human milk: Physiology and role in infant health. J Hum Lact. 2002;18:252–61. [PubMed: 12192960]
- 4.
-
Tokgöz B, Utas C, Dogukan A, et al. Influence of long term erythropoietin therapy on the hypothalamic-pituitary-thyroid axis in patients undergoing CAPD. Ren Fail. 2002;24:315–23. [PubMed: 12166698]
- 5.
-
Bernini GP, Mariotti F, Brogi G, et al. Effects of erythropoietin administration on prolactin secretion in normal subjects. Nephron. 1993;65:522–6. [PubMed: 8302403]
- 6.
-
Markianos M, Kosmidis ML, Sfagos C. Reductions in plasma prolactin during acute erythropoietin administration. Neuro Endocrinol Lett. 2006;27:355–8. [PubMed: 16816832]
Substance Identification
Substance Name
Epoetin Beta
CAS Registry Number
677324-53-7
Drug Class
Breast Feeding
Lactation
Colony-Stimulating Factors
Hematinics
Hematopoietic Cell Growth Factors
-
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
- Drug Levels and Effects
- Substance Identification