Is Laronidase compatible with breastfeeding? Do we have alternatives for Laronidase?

Laronidase

September 19, 2016 (Low Risk)

Recombinant-type of alfa-L-iduronidase that is used in enzyme replacement therapy in patients with Mucopolysaccharidosis I (MPS I).

Its high molecular weight explains the null passage observed in the milk of a nursing mother who had received weekly doses of Laronidase for three months, while she was breastfeeding. No physical or developmental problems in infants in the short or long term were observed.

Its low oral bioavailability hampers its passage from the breast milk ingested to the infant's plasma since it is degraded in the gastrointestinal tract due to its proteinaceous nature. It is not absorbed by the gut except in the immediate neonatal period or prematurity when intestinal permeability may be increased.

Weekly administration and short half life span allows, if desired, developing strategies to further minimize the risk of exposure (e.g. avoid breastfeeding between 4 and 8 hours after receiving a dose, using the "pump and dump method" of the breast milk while the baby is fed with previously extracted milk)

Alternatives

We do not have alternatives for Laronidase.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Alpha-L-iduronidase

Writings

  • لارونيداز (Arabic)
  • Ларонидаз (Cyrillic)
  • ラロニダーゼ (Japanese)

References

  1. EMA. Laronidase. Drug Summary. 2016 Full text (in our servers)
  2. EMA. Laronidasa. Ficha técnica. 2016 Full text (in our servers)
  3. Castorina M, Antuzzi D, Richards SM, Cox GF, Xue Y. Successful pregnancy and breastfeeding in a woman with mucopolysaccharidosis type I while receiving laronidase enzyme replacement. therapy. Clin Exp Obstet Gynecol. 2015Abstract