Attribution Statement: LactMed is a registered trademark of the U.S. Department of Health and Human Services.
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.
CASRN: 198153-51-4; 215647-85-1
Drug Levels and Effects
Summary of Use during Lactation
Although no information is available on peginterferon alfa in breastmilk, the levels of conventional interferon alfa in breastmilk are minuscule. In addition, because interferon is poorly absorbed orally, it is not likely to reach the bloodstream of the infant. Polyethylene glycol is not excreted into breastmilk.[1] It is unlikely that peginterferon alfa use by a nursing mother presents any serious risk to the breastfed infant.
For use in treating maternal hepatitis B, no differences exist in infection rates between breast-fed and formula-fed infants born to hepatitis B-infected women, as long as the infant receives hepatitis B immune globulin and hepatitis B vaccine at birth. Mothers with hepatitis B are encouraged to breastfeed their infants after their infants receive these preventative measures.[2,3]
Hepatitis C is not transmitted through breastmilk and breastmilk has been shown to inactivate hepatitis C virus (HCV).[4-7] However, the Centers for Disease Control recommends that mothers with HCV infection should consider abstaining from breastfeeding if their nipples are cracked or bleeding. It is not clear if this warning would apply to mothers who are being treated for hepatitis C.
Infants born to mothers with HCV infection should be tested for HCV infection; because maternal antibody is present for the first 18 months of life and before the infant mounts an immunologic response, nucleic acid testing is recommended.[4,7]
Drug Levels
No information is available specifically on peginterferon alfa. However, data are available on non-pegylated interferon alfa.
Maternal Levels. Two mothers taking interferon alfa had milk levels measured. One mother taking 8 million units three times a week had a milk level of 1400 units/L and another taking 8 million units daily had a milk level of 6000 units/L. Both levels were apparently measured immediately postpartum (in colostrum), but the time since the previous dose was not stated.[8]
An intravenous dose of 30 million units of interferon alfa-2B in one woman resulted in a peak milk level of 1551 International Units/L which was a slight increase over two baseline levels prior to the dose which averaged 1072 International Units/L. By 12 hours after the dose, milk interferon levels were lower than baseline.[9]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
One infant was born to a mother who received 3 million units of interferon alfa-2a subcutaneously 3 times weekly during pregnancy and postpartum for essential thrombocytopenia. Her infant was breastfed for 2 weeks postpartum before bilateral mastitis caused the mother to terminate nursing. The infant reportedly thrived, although specific measures were not mentioned.[10]
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
(Hepatitis B) Lamivudine, Tenofovir; (Hepatitis C) Interferon Alfa, Interferon Alfacon-1
References
- 1.
- Clowse ME, Förger F, Hwang C, et al. Minimal to no transfer of certolizumab pegol into breast milk: Results from CRADLE, a prospective, postmarketing, multicentre, pharmacokinetic study. Ann Rheum Dis 2017;76:1890-6. [PMC free article: PMC5705850] [PubMed: 28814432]
- 2.
- Visvanathan K, Dusheiko G, Giles M, et al. Managing HBV in pregnancy. Prevention, prophylaxis, treatment and follow-up: Position paper produced by Australian, UK and New Zealand key opinion leaders. Gut 2016;65:340-50. [PubMed: 26475631]
- 3.
- Dionne-Odom J, Tita AT, Silverman NS. #38: Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission. Am J Obstet Gynecol 2016;214:6-14. [PubMed: 26454123]
- 4.
- Cottrell EB, Chou R, Wasson N, et al. Reducing risk for mother-to-infant transmission of hepatitis C virus: A systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2013;158:109-13. [PubMed: 23437438]
- 5.
- Pfaender S, Heyden J, Friesland M, et al. Inactivation of hepatitis C virus infectivity by human breast milk. J Infect Dis 2013;208:1943-52. [PubMed: 24068703]
- 6.
- Tovo PA, Calitri C, Scolfaro C, et al. Vertically acquired hepatitis C virus infection: Correlates of transmission and disease progression. World J Gastroenterol 2016;22:1382-92. [PMC free article: PMC4721973] [PubMed: 26819507]
- 7.
- Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep 2021;70:1-187. [PMC free article: PMC8344968] [PubMed: 34292926]
- 8.
- Haggstrom J, Adriansson M, Hybbinette T, et al. Two cases of CML treated with alpha-interferon during second and third trimester of pregnancy with analysis of the drug in the new-born immediately postpartum. Eur J Haematol 1996;57:101-2. [PubMed: 8698119]
- 9.
- Kumar AR, Hale TW, Mock RE. Transfer of interferon alfa into human breast milk. J Hum Lact 2000;16:226-8. [PubMed: 11153157]
- 10.
- Williams JM, Schlesinger PE, Gray AG. Successful treatment of essential thrombocythaemia and recurrent abortion with alpha interferon. Br J Haematol 1994;88:647-8. [PubMed: 7819084]
Substance Identification
Substance Name
Peginterferon Alfa
CAS Registry Number
198153-51-4; 215647-85-1
Drug Class
Breast Feeding
Lactation
Milk, Human
Antiviral Agents
Biological Response Modifiers
Antineoplastic Agents
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.
- User and Medical Advice Disclaimer
- Drugs and Lactation Database (LactMed) - Record Format
- LactMed - Database Creation and Peer Review Process
- Fact Sheet. Drugs and Lactation Database (LactMed)
- Drugs and Lactation Database (LactMed) - Glossary
- LactMed Selected References
- Drugs and Lactation Database (LactMed) - About Dietary Supplements
- Breastfeeding Links
- Review Interferon Alfa.[Drugs and Lactation Database (...]Review Interferon Alfa.. Drugs and Lactation Database (LactMed®). 2006
- Review Boceprevir.[Drugs and Lactation Database (...]Review Boceprevir.. Drugs and Lactation Database (LactMed®). 2006
- Review Interferon Alfacon-1.[Drugs and Lactation Database (...]Review Interferon Alfacon-1.. Drugs and Lactation Database (LactMed®). 2006
- Simeprevir with pegylated interferon alfa 2a or 2b plus ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection (QUEST-2): a randomised, double-blind, placebo-controlled phase 3 trial.[Lancet. 2014]Simeprevir with pegylated interferon alfa 2a or 2b plus ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection (QUEST-2): a randomised, double-blind, placebo-controlled phase 3 trial.Manns M, Marcellin P, Poordad F, de Araujo ES, Buti M, Horsmans Y, Janczewska E, Villamil F, Scott J, Peeters M, et al. Lancet. 2014 Aug 2; 384(9941):414-26. Epub 2014 Jun 4.
- Review Peginterferon Beta.[Drugs and Lactation Database (...]Review Peginterferon Beta.. Drugs and Lactation Database (LactMed®). 2006
- Peginterferon Alfa - Drugs and Lactation Database (LactMed®)Peginterferon Alfa - Drugs and Lactation Database (LactMed®)
Your browsing activity is empty.
Activity recording is turned off.
See more...