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

Lenograstim

November 15, 2015 (Very Low Risk)

Non-glycosylated stimulating factor of granulocyte colonies (G-CSF) which is obtained by recombinant technology. It has similar action and indication than Filgrastim. The naturally occurring product is found in breast milk.
It is indicated for the treatment of cancer-related neutropenia and severe congenital neutropenia.

A very high molecular weight explains the insignificant or no excretion into milk that has been observed both with Lenograstim and Filgrastim.

Its low oral bioavailability hampers absorption into infant plasma from the breast milk ingested, as for their proteic nature it is degraded in the gastrointestinal tract, not being absorbed. Filgrastim is not absorbed by the infant's gut even during the neonatal period or prematurity.

The granulocyte colony-stimulating factor (Filgrastim) has been used in premature newborns, both on prevention and treatment of neonatal sepsis and/or necrotizing enterocolitis without adverse effects being observed among treated infants.

The bovine G-CSF is found in the usual diet of meat eaters.

Alternatives

We do not have alternatives for Lenograstim since it is relatively safe.

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

  • Glycosylated recombinant G-CSF

Writings

  • لينوغراستيم (Arabic)
  • Ленограстим (Cyrillic)
  • 来格司亭 (Chinese)
  • レノグラスチム (Japanese)

Drug trade names

References

  1. Pessach I, Shimoni A, Nagler A. Granulocyte-colony stimulating factor for hematopoietic stem cell donation from healthy female donors during pregnancy and lactation: what do we know? Hum Reprod Update. 2013Abstract Full text (link to original source) Full text (in our servers)
  2. Pistilli B, Bellettini G, Giovannetti E, Codacci-Pisanelli G, Azim HA Jr, Benedetti G, Sarno MA, Peccatori FA. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: how should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013Abstract
  3. AEMPS. Lenograstim. Ficha técnica. 2009 Full text (in our servers)
  4. Kaida K, Ikegame K, Fujioka T, Taniguchi Y, Inoue T, Hasei H, Tamaki H, Yoshihara S, Kawase I, Ogawa H. Kinetics of granulocyte colony-stimulating factor in the human milk of a nursing donor receiving treatment for mobilization of the peripheral blood stem cells. Acta Haematol. 2007Abstract Full text (link to original source) Full text (in our servers)
  5. Canpolat FE, Yurdakök M, Korkmaz A, Yiğit S, Tekinalp G. Enteral granulocyte colony-stimulating factor for the treatment of mild (stage I) necrotizing enterocolitis: a placebo-controlled pilot study. J Pediatr Surg. 2006Abstract
  6. Martino M, Console G, Irrera G, Callea I, Condemi A, Dattola A, Messina G, Pontari A, Pucci G, Furlò G, Bresolin G, Iacopino P, Morabito F. Harvesting peripheral blood progenitor cells from healthy donors: retrospective comparison of filgrastim and lenograstim. J Clin Apher. 2005Abstract
  7. Calhoun DA, Maheshwari A, Christensen RD. Recombinant granulocyte colony-stimulating factor administered enterally to neonates is not absorbed. Pediatrics. 2003Abstract
  8. Carr R, Modi N, Doré C. G-CSF and GM-CSF for treating or preventing neonatal infections. Cochrane Database Syst Rev. 2003Abstract
  9. Shibata H, Yamane T, Aoyama Y, Nakamae H, Hasegawa T, Sakamoto C, Terada Y, Koh G, Hino M. Excretion of granulocyte colony-stimulating factor into human breast milk. Acta Haematol. 2003Abstract Full text (link to original source) Full text (in our servers)
  10. Bedford Russell AR, Emmerson AJ, Wilkinson N, Chant T, Sweet DG, Halliday HL, Holland B, Davies EG. A trial of recombinant human granulocyte colony stimulating factor for the treatment of very low birthweight infants with presumed sepsis and neutropenia. Arch Dis Child Fetal Neonatal Ed. 2001Abstract Full text (link to original source) Full text (in our servers)
  11. Gillan ER, Christensen RD, Suen Y, Ellis R, van de Ven C, Cairo MS. A randomized, placebo-controlled trial of recombinant human granulocyte colony-stimulating factor administration in newborn infants with presumed sepsis: significant induction of peripheral and bone marrow neutrophilia. Blood. 1994Abstract Full text (link to original source) Full text (in our servers)