Summary of Use during Lactation

Although siponimod is highly bound in maternal plasma and unlikely to reach the breastmilk in large amounts, it is potentially toxic to the breastfed infant. Because there is no published experience with siponimod during breastfeeding, expert opinion generally recommends that the closely related drug fingolimod should be avoided during breastfeeding, especially while nursing a newborn or preterm infant.[1-6] However, the manufacturer's labeling does not recommend against the use of siponimod in breastfeeding.

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

(Multiple Sclerosis) Glatiramer, Immune Globulin, Interferon Beta

References

1.

Bove R, Alwan S, Friedman JM, et al. Management of multiple sclerosis during pregnancy and the reproductive years: A systematic review. Obstet Gynecol. 2014;124:1157–68. [PubMed: 25415167]

2.

Cree BA. Update on reproductive safety of current and emerging disease-modifying therapies for multiple sclerosis. Mult Scler. 2013;19:835–43. [PubMed: 23319073]

3.

Houtchens MK, Kolb CM. Multiple sclerosis and pregnancy: Therapeutic considerations. J Neurol. 2013;260:1202–14. [PubMed: 22926165]

4.

Almas S, Vance J, Baker T, et al. Management of multiple sclerosis in the breastfeeding mother. Mult Scler Int. 2016;2016:6527458. [PMC free article: PMC4757692] [PubMed: 26966579]

5.

Kaplan TB. Management of demyelinating disorders in pregnancy. Neurol Clin. 2019;37:17–30. [PubMed: 30470273]

6.

Dobson R, Dassan P, Roberts M, et al. UK consensus on pregnancy in multiple sclerosis: 'Association of British Neurologists' guidelines. Pract Neurol. 2019;19:106–14. [PubMed: 30612100]

Substance Name

Siponimod

CAS Registry Number

1230487-00-9

Drug Class

Breast Feeding

Lactation

Immunosuppressive Agents

Sphingosine 1 Phosphate Receptor Modulators