Is Etravirine 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 Etravirine. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Etravirine is excreted in breastmilk in concentrations exceeding the maternal plasma and appears to increase in concentration over time. Until more information becomes available, an alternate agent may be preferred. Achieving and 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]
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. Nine HIV-positive women had etravirine added to their existing antiretroviral regimens between postpartum days 1 and 14 postpartum. The dosage was not stated, but was presumably 200 mg twice daily. Breastmilk and maternal serum samples were obtained at 0, 2, 5, 8 and 24 hours after the dose of etravirine on days 5 and 14 postpartum. The median breastmilk concentration of etravirine on day 5 was 241 mcg/L (range 161 to 891 mcg/L) and on day 14 was 798 mcg/L (range 161 to 2714 mcg/L). The median milk to plasma ratio was 1.09 on day 5 and 3.27 on day 14.[3]
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 Etravirine 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 “Etravirine” (LM655). 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.