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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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Last Revision: February 15, 2021.

Estimated reading time: 1 minute

CASRN: 267639-76-9

Drug Levels and Effects

Summary of Use during Lactation

No information is available on the excretion of romiplostim into breastmilk. Because romiplostim is a large protein molecule with a molecular weight of 29,544 Da., 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. Information from one mother-infant pair indicates that no short-term adverse effects occurred in the infant after maternal romiplostim. Until more data become available, romiplostim should be used with careful infant monitoring during breastfeeding, especially while nursing a newborn or preterm infant.

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 woman with chronic immune thrombocytopenic purpura had a low platelet count after delivery even after receiving 5 units of platelets on two consecutive days. She also received intravenous methylprednisolone 500 mg daily for 2 days and intravenous immune globulin 1 gram/kg with poor response. The patient was given romiplostim 2 mcg/kg and 90 mg of prednisone orally on the evening of postpartum day 2 at about 68 hours postpartum. She received a second dose of 2 mcg/kg romiplostim on the third postpartum day. Her platelet count increased and she was discharged on postpartum day 5. The patient elected to breastfeed her infant (extent not stated). No adverse effects were noted in the infant during the hospitalization.[1]

Effects on Lactation and Breastmilk

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


Patras A, Figueroa R, Singh AP, et al. Romiplostim for management of refractory immune thrombocytopenic purpura in the immediate postpartum period. BMJ Case Rep. 2020;13:e234335. [PMC free article: PMC7239498] [PubMed: 32430352]

Substance Identification

Substance Name


CAS Registry Number


Drug Class

Breast Feeding


Recombinant Fusion Proteins


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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