Is RimabotulinumtoxinB 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 RimabotulinumtoxinB. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
No data exist on the medical use of rimabotulinumtoxinB during breastfeeding. However, it is not detectable systemically after intramuscular use, thus excretion into breast milk is considered unlikely. The closely related drug, onabotulinumtoxinA was not detectable in the milk of two women and detectable in only minute amounts in 5 others after 40 to 92 units injected into the face. Many mothers have breastfed their infants after injection of onabotulinumtoxinA for migraine.[1] An international guideline considers onabotulinumtoxinA acceptable in breastfeeding women with chronic migraine.[2] No special precautions are required.
Effects on the breastfed infant
One mother breastfed her infant while she was experiencing toxicity from botulism poisoning. She breastfed her 2-month-old infant. Although the mother died, the infant had no symptoms.[4]
A woman developed botulism after ingesting fermented salmon eggs while breastfeeding her 8-month-old breastfed (extent not stated) infant. The infant developed no signs or symptoms of botulism even though she continued to nurse throughout the mother's hospitalization.[3]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Published information on the medical use of rimabotulinumtoxinB during breastfeeding was not found as of the revision date.
Type A botulinum toxin was detected in the blood and stools of a nursing mother after ingesting fermented salmon eggs. She was given 2 vials of trivalent botulism antitoxin, 1 intravenously and 1 intramuscularly. A milk sample obtained 3 days after the onset of her illness and 4 hours after administration of botulinum antitoxin had no detectable botulinum toxin nor botulism organisms.[3]
Infant Levels. Type A botulinum toxin was detected in the blood and stools of a nursing mother after ingesting fermented salmon eggs. No botulinum toxin was detected in the breastfed infant's blood or stool on the day the mother was admitted to the hospital (3 days after the onset of illness) and no botulism organisms were detected in the infant's stools.[3]
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “RimabotulinumtoxinB” (rimabotulinumtoxinB). 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.