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Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.

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Drugs and Lactation Database (LactMed) [Internet].

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Tildrakizumab

Last Revision: February 15, 2021.

Estimated reading time: 1 minute

CASRN: 1326244-10-3

Drug Levels and Effects

Summary of Use during Lactation

No information is available on the clinical use of tildrakizumab during breastfeeding. Because tildrakizumab is a large protein molecule with a molecular weight of 147,000 Da, absorption by the infant is unlikely after the first few weeks postpartum, and it will probably be destroyed in the infant's gastrointestinal tract. Some professional guidelines feel that the drug is acceptable to use during breastfeeding.[1] Until more data become available, tildrakizumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.

Tildrakizumab is a human immunoglobulin G1 (IgG1) kappa antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[2,3] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%. Specific IgG subclasses decreased by different amounts, with IgG1 activity decreasing by about 37%.[4] None of the studies measured IgG activity.

Drug Levels

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.
Smith CH, Yiu ZZN, Bale T, et al. British Association of Dermatologists guidelines for biologic therapy for psoriasis 2020: A rapid update. Br J Dermatol. 2020;183:628–37. [PubMed: 32189327]
2.
Koenig A, de Albuquerque Diniz EM, Barbosa SF, et al. Immunologic factors in human milk: The effects of gestational age and pasteurization. J Hum Lact. 2005;21:439–43. [PubMed: 16280560]
3.
Adhisivam B, Vishnu Bhat B, Rao K, et al. Effect of Holder pasteurization on macronutrients and immunoglobulin profile of pooled donor human milk. J Matern Fetal Neonatal Med. 2019;32:3016–9. [PubMed: 29587541]
4.
Rodríguez-Camejo C, Puyol A, Fazio L, et al. Antibody profile of colostrum and the effect of processing in human milk banks: Implications in immunoregulatory properties. J Hum Lact. 2018;34:137–47. [PubMed: 28586632]

Substance Identification

Substance Name

Tildrakizumab

CAS Registry Number

1326244-10-3

Drug Class

Breast Feeding

Lactation

Antibodies, Monoclonal, Humanized

Dermatologic Agents

Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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