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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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Alglucerase

Last Revision: April 20, 2020.

Estimated reading time: 1 minute

CASRN: 37228-64-1

Drug Levels and Effects

Summary of Use during Lactation

Alglucerase is the placenta-derived form of the enzyme, beta-glucocerebrosidase which is a normal component of human milk. Studies with alclucerase and synthetic forms of the enzyme have found very low levels of the enzyme in breastmilk. Absorption is unlikely because it is probably destroyed in the infant's gastrointestinal tract.[1,2] A limited amount of data support the safety of breastfeeding with alglucerase. An international panel of clinicians from 9 centers that treat Gaucher's disease reported that, breastfeeding complications were less frequent in mothers who were treated with alglucerase or imiglucerase (a biosynthetic form of the enzyme) postpartum than in untreated mothers with Gaucher's disease. Consider limiting the duration of breastfeeding to about 6 months to avoid excessive bone loss in the nursing mother.[2,3]

Drug Levels

Maternal Levels. One woman received 60 units/kg of alglucerase intravenously. Alglucerase appeared in breastmilk in levels above the baseline control values at 2, 6, 12, 24 and 48 hours postinfusion. Concentrations ranged between 69 and 187 ng/L above baseline.[4]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

One woman received alglucerase 30 international units/kg intravenously every 2 weeks during pregnancy and lactation. Her breastfed infant reportedly grew and developed normally.[5]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Imiglucerase, Taliglucerase Alfa

References

1.
Belmatoug N. Considerations for pregnant patients with Gaucher disease: challenges for the patient and physician. Clin Ther. 2009;31 Suppl. C:S192–S3. [CrossRef]
2.
Zimran A, Morris E, Mengel E, et al. The female Gaucher patient: The impact of enzyme replacement therapy around key reproductive events (menstruation, pregnancy and menopause). Blood Cells Molec Dis. 2009;43:264–88. [PubMed: 19502088]
3.
Granovsky-Grisaru S, Belmatoug N, vom Dahl S, et al. The management of pregnancy in Gaucher disease. Eur J Obstet Gynecol Reprod Biol. 2011;156:3–8. [PubMed: 21269752]
4.
Esplin J, Greenspoon JS, Cheng E, et al. Alglucerase infusions in pregnant type 1 Gaucher patients. Blood. 1993;82:509a. Abstract 2020.
5.
Aporta Rodriguez R, Escobar Vedia JL, Navarro Castro AM, et al. Alglucerase enzyme replacement therapy used safely and effectively throughout the whole pregnancy of a Gaucher disease patient. Haematologica. 1998;83:852–3. [PubMed: 9825582]

Substance Identification

Substance Name

Alglucerase

CAS Registry Number

37228-64-1

Drug Class

Breast Feeding

Lactation

Enzymes

Enzyme Replacement Therapy

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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