Is Cabotegravir safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Cabotegravir. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
A pharmacokinetic analysis found low levels of cabotegravir in breastmilk with maternal use of long-acting cabotegravir. Maintaining viral suppression with antiretroviral therapy decreases breastfeeding transmission risk to less than 1%, but not zero. Individuals with HIV who are on antiretroviral therapy with a sustained undetectable viral load and who choose to breastfeed should be supported in this decision. If a viral load is not suppressed, banked pasteurized donor milk or formula is recommended.[1,2] Extended postnatal prophylaxis of breastfed infants with cabotegravir should continue until breastfeeding is stopped.[3]
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. An abstract reports a study in which long-acting cabotegravir 600 mg was injected intramuscularly every 56 days to 27 nursing mothers. Median breastmilk concentrations at these times were 14.6 mcg/L just before the 1-month injection, 29.8 mcg/L one week later, 27.4 mcg/L just before the 5-month injection, and 36.1 mcg/L one week later.[4]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Cabotegravir is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Cabotegravir” (cabotegravir). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.