Ponesimod and Breastfeeding

Summary of use during lactation

Although ponesimod is highly bound in maternal plasma and unlikely to reach the breastmilk in large amounts, it has a slow clearance and long half-life and is potentially toxic to the breastfed infant, it has a slow clearance and long half-life and is potentially toxic to the breastfed infant. Because there is no published experience with ponesimod during breastfeeding, expert opinion generally recommends that the closely related drug fingolimod should be avoided during breastfeeding, especially while nursing a newborn or preterm infant.[1-6] However, the manufacturer's labeling does not recommend against the use of ponesimod in breastfeeding.

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

(Multiple Sclerosis) Glatiramer, Immune Globulin, Interferon Beta

References

1. Bove R, Alwan S, Friedman JM, et al. Management of multiple sclerosis during pregnancy and the reproductive years: A systematic review. Obstet Gynecol 2014;124:1157-68.25415167 PubMed
2. Cree BA. Update on reproductive safety of current and emerging disease-modifying therapies for multiple sclerosis. Mult Scler 2013;19:835-43.23319073 PubMed
3. Houtchens MK, Kolb CM. Multiple sclerosis and pregnancy: Therapeutic considerations. J Neurol 2013;260:1202-14.22926165 PubMed
4. Almas S, Vance J, Baker T, et al. Management of multiple sclerosis in the breastfeeding mother. Mult Scler Int 2016;2016:6527458.26966579 PubMed
5. Kaplan TB. Management of demyelinating disorders in pregnancy. Neurol Clin 2019;37:17-30.30470273 PubMed
6. Dobson R, Dassan P, Roberts M, et al. UK consensus on pregnancy in multiple sclerosis: 'Association of British Neurologists' guidelines. Pract Neurol 2019;19:106-14.30612100 PubMed