Etesevimab and Bamlanivimab and Breastfeeding

Summary of use during lactation

The distribution of etesevimab and bamlanivimab was stopped in June of 2021 because of a lack of efficacy against COVID-19 variants. Etesevimab and bamlanivimab are monoclonal antibodies directed against the SARS-CoV-2 virus that causes COVID-19. No information is available on their clinical use during breastfeeding. Because etesevimab and bamlanivimab are large protein molecules with molecular weights of 146,000 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]

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