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Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.
CASRN: 198153-51-4; 215647-85-1


Drug Levels and Effects
Summary of Use during Lactation
Although no information is available on peginterferon alfa in breastmilk, the levels of conventional interferon alfa in breastmilk are minuscule. In addition, because interferon is poorly absorbed orally, it is not likely to reach the bloodstream of the infant. It is unlikely that peginterferon alfa use by a nursing mother presents any serious risk to the breastfed infant. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of the related endogenous interferon-gamma by an average about 10%.[1]
For use in treating maternal hepatitis B, no difference exist in infection rates between breast-fed and formula-fed infants born to hepatitis B-infected women, as long as the infant receives hepatitis B immune globulin and hepatitis B vaccine at birth. Mothers with hepatitis B are encouraged to breastfeed their infants after their infants receive these preventative measures.[2][3]
Drug Levels
No information is available specifically on peginterferon alfa. However, data are available on non-pegylated interferon alfa.
Maternal Levels. Two mothers taking interferon alfa had milk levels measured. One mother taking 8 million units three times a week had a milk level of 1400 units/L and another taking 8 million units/day had a milk level of 6000 units/L. Both levels were apparently measured immediately postpartum (in colostrum), but the time since the previous dose was not stated.[4]
An intravenous dose of 30 million units of interferon alfa-2B in one woman resulted in a peak milk level of 1551 International Units/L which was a slight increase over two baseline levels prior to the dose which averaged 1072 International Units/L. By 12 hours after the dose, milk interferon levels were lower than baseline.[5]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
One infant was born to a mother who received 3 million units of interferon alfa-2a subcutaneously 3 times weekly during pregnancy and postpartum for essential thrombocytopenia. Her infant was breastfed for 2 weeks postpartum before bilateral mastitis caused the mother to terminate nursing. The infant reportedly thrived, although specific measures were not mentioned.[6]
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
(Hepatitis B) Lamivudine, Tenofovir; (Hepatitis C) Interferon Alfa, Interferon Alfacon-1
References
- 1.
- Ewaschuk JB, Unger S, O'Connor DL et al. Effect of pasteurization on selected immune components of donated human breast milk. J Perinatol. 2011;31:593-8. [PubMed: 21330996]
- 2.
- Visvanathan K, Dusheiko G, Giles M et al. Managing HBV in pregnancy. Prevention, prophylaxis, treatment and follow-up: Position paper produced by Australian, UK and New Zealand key opinion leaders. Gut. 2016;65:340-50. [PubMed: 26475631]
- 3.
- Dionne-Odom J, Tita AT, Silverman NS. #38: Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission. Am J Obstet Gynecol. 2016;214:6-14. [PubMed: 26454123]
- 4.
- Haggstrom J, Adriansson M, Hybbinette T et al. Two cases of CML treated with alpha-interferon during second and third trimester of pregnancy with analysis of the drug in the new-born immediately postpartum. Eur J Haematol. 1996;57:101-2. Letter. [PubMed: 8698119]
- 5.
- Kumar AR, Hale TW, Mock RE. Transfer of interferon alfa into human breast milk. J Hum Lact. 2000;16:226-8. [PubMed: 11153157]
- 6.
- Williams JM, Schlesinger PE, Gray AG. Successful treatment of essential thrombocythaemia and recurrent abortion with alpha interferon. Br J Haematol. 1994;88:647-8. [PubMed: 7819084]
Substance Identification
Substance Name
Peginterferon Alfa
CAS Registry Number
198153-51-4; 215647-85-1
Drug Class
- Breast Feeding
- Antiviral Agents
- Biological Response Modifiers
- Antineoplastic Agents
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- Review Interferon Alfa[Drugs and Lactation Database (...]Review Interferon Alfa. Drugs and Lactation Database (LactMed). 2006
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- Simeprevir with pegylated interferon alfa 2a or 2b plus ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection (QUEST-2): a randomised, double-blind, placebo-controlled phase 3 trial.[Lancet. 2014]Simeprevir with pegylated interferon alfa 2a or 2b plus ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection (QUEST-2): a randomised, double-blind, placebo-controlled phase 3 trial.Manns M, Marcellin P, Poordad F, de Araujo ES, Buti M, Horsmans Y, Janczewska E, Villamil F, Scott J, Peeters M, et al. Lancet. 2014 Aug 2; 384(9941):414-26. Epub 2014 Jun 4.
- Review Pegylated interferons for the treatment of chronic hepatitis C: pharmacological and clinical differences between peginterferon-alpha-2a and peginterferon-alpha-2b.[Drugs. 2010]Review Pegylated interferons for the treatment of chronic hepatitis C: pharmacological and clinical differences between peginterferon-alpha-2a and peginterferon-alpha-2b.Foster GR. Drugs. 2010; 70(2):147-65.
- Review The clinical effectiveness and cost-effectiveness of peginterferon alfa and ribavirin for the treatment of chronic hepatitis C in children and young people: a systematic review and economic evaluation.[Health Technol Assess. 2014]Review The clinical effectiveness and cost-effectiveness of peginterferon alfa and ribavirin for the treatment of chronic hepatitis C in children and young people: a systematic review and economic evaluation.Hartwell D, Cooper K, Frampton GK, Baxter L, Loveman E. Health Technol Assess. 2014 Oct; 18(65):i-xxii, 1-202.