Summary of Use during Lactation

Emergency use authorization for sotrovimab has been withdrawn in the US because of its poor activity against some Omicron strains of SARS- CoV-2. Sotrovimab is a monoclonal antibody directed against the SARS-CoV-2 virus that causes COVID-19. No information is available on the clinical use of sotrovimab during breastfeeding. Because sotrovimab is a large protein molecule, the amount in milk is likely to be very low. It is also likely to be partially destroyed in the infant's gastrointestinal tract and absorption by the infant is probably minimal. Similar anti-SARS-CoV-2 monoclonal antibodies were used during pregnancy and lactation in one mother with no adverse consequences.[1] Until more data become available, sotrovimab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.

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

Nirmatrelvir, Remdesevir

References

1.

Ogawa E, Goto H, Ushimaru H, et al. Vaginal delivery after improvement in COVID-19 by monoclonal antibody treatment: A case report and literature review. J Infect Chemother. 2022;28:982–6. PMID. [PMC free article: PMC8898669] [PubMed: 35288022]

Substance Name

Sotrovimab

CAS Registry Number

2423014-07-5

Drug Class

Breast Feeding

Lactation

Milk, Human

Antibodies, Monoclonal, Humanized

Antibodies, Viral

Antiviral Agents