Mepolizumab

Summary of Use during Lactation

No information is available on the clinical use of mepolizumab during breastfeeding. Because mepolizumab is a large protein molecule with a molecular weight of 149,000 Da, the amount in milk is likely to be very low.[1] It is also likely to be partially destroyed in the infant's gastrointestinal tract and absorption by the infant is probably minimal.[2] A task force respiratory experts from Europe, Australia and New Zealand found that mepolizumab is possibly acceptable during breastfeeding and an international consensus panel concluded that if the patient is in agreement, and the risks and benefits have been discussed, asthma biologics can be initiated or continued while breastfeeding.[3,4] Waiting for at least 2 weeks postpartum to resume therapy may minimize transfer to the infant.[5]

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

(Asthma) Benralizumab, Omalizumab

References

1.

Stratigakis A, Paty D, Zou P, et al. A regression approach for assessing large molecular drug concentration in breast milk. Reprod Breed 2023;3:199-207. doi:10.1016/j.repbre.2023.10.003 [CrossRef]

2.

Anderson PO. Monoclonal antibodies during breastfeeding. Breastfeed Med 2021;16:591-3. [PubMed: 33956488]

3.

Middleton PG, Gade EJ, Aguilera C, et al. ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases. Eur Respir J 2020;55:1901208. [PubMed: 31699837]

4.

Naftel J, Jackson DJ, Coleman M, et al. An international consensus on the use of asthma biologics in pregnancy. Lancet Respir Med 2024. [PubMed: 39216499]

5.

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

Mepolizumab

CAS Registry Number

196078-29-2

Drug Class

Breast Feeding

Lactation

Milk, Human

Anti-Allergic Agents

Anti-Asthmatic Agents

Antibodies, Monoclonal, Humanized