Ziv-Aflibercept and Breastfeeding

Summary of use during lactation

This record refers to the use of ziv-aflibercept for treating cancer. No information is available on the use of ziv-aflibercept during breastfeeding. Because ziv-aflibercept is a large protein molecule with a molecular weight of 115,000, 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. However, ziv-aflibercept is usually used in combination with other potentially toxic chemotherapy agents and most sources consider breastfeeding to be contraindicated during maternal antineoplastic drug therapy. Intravitreal aflibercept decreased vascular endothelial growth factor in breastmilk in one woman.[1] Since VEGF is present in human milk and is thought to help in maturation of the infant’s gastrointestinal tract, concern has been raised about the maternal use of VEGF inhibitors during breastfeeding. Note that the typical alternative to breastmilk is infant formula, which contains no VEGF.

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.

References

1. JuncalVR ParachaQ BamakridM Ranibizumab and aflibercept levels in breast milk after intravitreal injection. Ophthalmology 2020 127 278 80 31526521 PubMed