Summary of use during lactation
Taliglucerase alfa is a biosynthetic synthetic enzyme closely related to beta-glucocerebrosidase, which is a normal component of human milk. Because it is a large protein molecule with a molecular weight of about 61,000 Da, the amount in milk is likely to be very low and absorption is unlikely because it is probably destroyed in the infant’s gastrointestinal tract.[1,2] International panels of clinicians that treat Gaucher’s disease recommend breastfeeding with enzyme replacement therapy such as imiglucerase.[2,3] Consider limiting the duration of breastfeeding to about 6 months to avoid excessive bone loss in the nursing mother.[2–4]
Drug levels in milk and infant serum
Maternal Levels. A woman with Gaucher disease received taliglucerase alfa 20 units/kg intravenously every 2 weeks during pregnancy and postpartum during breastfeeding. One month after delivery, breastmilk samples were collected before, immediately after, and 30 minutes after an infusion of the drug. Beta-glucocerebrosidase activity in breastmilk were: 3.9 nmol/hour/mL before the infusion, 7.1 nmol/hour/mL immediately after infusion, and 7.2 nmol/hour/mL 30 minutes after infusion. These values are lower than those found in the milk of mothers treated with other replacement enzymes. The woman breastfed her infant exclusively on demand through 10 months of age.[5] 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
Alglucerase, Imiglucerase
Source: Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, NCBI Bookshelf. Check LactMed for the most recent revision.
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