Bebtelovimab and Breastfeeding

Summary of use during lactation

The US FDA has withdrawn emergency-use authorization for bebtelovimab because of its poor activity against some Omicron strains of SARS- CoV-2. Bebtelovimab is a monoclonal antibody directed against the SARS-CoV-2 virus that causes COVID-19. No information is available on the clinical use of bebtelovimab during breastfeeding. Because bebtelovimab is a large protein molecule, 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] Similar anti-SARS-CoV-2 monoclonal antibodies were used during pregnancy and lactation in one mother with no adverse consequences.[3] Until more data become available, bebtelovimab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.

Drug levels in milk and infant serum

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.

Alternative drugs to consider

Nirmatrelvir, Remdesevir

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
2. Anderson PO. Monoclonal antibodies during breastfeeding. Breastfeed Med 2021;16:591-3.33956488 PubMed
3. Ogawa E, Goto H, Ushimaru H, et al. Vaginal delivery after improvement in COVID-19 by monoclonal antibody treatment: A case report and literature review. J Infect Chemother 2022;28:982-6.35288022 PubMed