Is Erenumab 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 Erenumab. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
No information is available on the passage of erenumab into breastmilk. Because erenumab is a large protein molecule with a molecular weight of 150,000 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] Two infants have been breastfed during maternal erenumab therapy without any adverse effects. Until more data become available, erenumab injection should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. Waiting for at least 2 weeks postpartum to resume therapy may minimize transfer to the infant.[3]
Effects on the breastfed infant
A postpartum woman who was nursing her 21-month-old infant twice daily had chronic migraine unresponsive to conventional treatment. Erenumab was begun at a dose of 70 mg (presumably subcutaneously once monthly). The mother noted no adverse effects in the infant over the following 5 months. The infant developed adequately, and each of seven mandatory childhood check-ups was normal. No infections occurred, and no problems with nutrition were noted.[4]
A woman with a long history of migraine received subcutaneous erenumab 70 mg monthly during pregnancy and postpartum. After delivery, she partially breastfed her infant in an unspecified proportion of breastmilk. The mother was told the baby was meeting normal developmental milestones at visits with the baby’s pediatrician. At the 6-month pediatrician visit, the baby’s weight was 8.15 kg (80th percentile), height 71.8 cm (>95th percentile), and head circumference 43.2 cm (75th percentile).[5]
A review of the database of reports of suspected adverse reactions maintained by the World Health Organization identified one report of an infant who experienced poor feeding during maternal use of erenumab. No further details were provided.[6]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
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.
Alternatives LactMed lists
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Erenumab” (LM1386). 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.