Summary of Use during Lactation

Three infants were breastfed without harm by mothers taking ravulizumab. Because ravulizumab is a large protein molecule with a molecular weight of about 148,000 Da, absorption is unlikely because it is probably destroyed in the infant's gastrointestinal tract. Waiting for at least 2 weeks postpartum to resume therapy may minimize transfer to the infant.[1] The manufacturer recommends that breastfeeding be discontinued during ravulizumab therapy and for 8 months after the final dose.

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

A single-center, retrospective review of 19 women who received ravulizumab during pregnancy and postpartum revealed 16 mothers who breastfed during ravulizumab therapy. After a median follow-up of 16.2 months (IQR 4.4 to 40.1 months), no developmental abnormalities or severe infectious complications were observed in the children.[2]

Effects on Lactation and Breastmilk

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

Alternate Drugs to Consider

Eculizumab

References

1.

Krysko KM, Dobson R, Alroughani R, et al. Family planning considerations in people with multiple sclerosis. Lancet Neurol 2023;22:350-66 . [PubMed: 36931808]

2.

Höchsmann B, Gerber GF, Leopold W, et al. Ravulizumab for treatment of paroxysmal nocturnal hemoglobinuria during pregnancy. Blood Adv 2026 . [PubMed: 41610317]

Substance Name

Ravulizumab

CAS Registry Number

1803171-55-2

Drug Class

Breast Feeding

Lactation

Milk, Human

Antibodies, Monoclonal