The Basics
What is C1 Esterase Inhibitor?
Used to help prevent swelling problems that occur with hereditary angioedema-HAE.
Brand names for C1 Esterase Inhibitor
Berinert
How C1 Esterase Inhibitor is classified
Complement C1 Inactivator Proteins
C1 Esterase Inhibitor During Pregnancy
C1 Esterase Inhibitor pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking C1 Esterase Inhibitor while pregnant
N/A
Taking C1 Esterase Inhibitor While Breastfeeding
What are recommendations for lactation if you're taking C1 Esterase Inhibitor?
C1 esterase inhibitor [human] is a serine proteinase inhibitor derived from human plasma that is used in treating hereditary angioedema. Breastmilk levels of C1 esterase inhibitor have not been measured after exogenous administration in humans. Because of its large molecular weight, amounts in milk are expected to be small. Any C1 esterase inhibitor in breastmilk is probably destroyed in the infant’s gastrointestinal tract and not absorbed, except perhaps in neonates. Various international consensus panels state that human plasma-derived C1 esterase inhibitor is considered to be the therapy of choice for both treatment and prophylaxis of maternal hereditary angioedema during lactation.[1][2]
Maternal / infant drug levels
C1 esterase inhibitor [human] is a serine proteinase inhibitor derived from human plasma that is used in treating hereditary angioedema. Breastmilk levels of C1 esterase inhibitor have not been measured after exogenous administration in humans. Because of its large molecular weight, amounts in milk are expected to be small. Any C1 esterase inhibitor in breastmilk is probably destroyed in the infant’s gastrointestinal tract and not absorbed, except perhaps in neonates. Various international consensus panels state that human plasma-derived C1 esterase inhibitor is considered to be the therapy of choice for both treatment and prophylaxis of maternal hereditary angioedema during lactation.[1][2]
Possible effects of C1 Esterase Inhibitor on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to C1 Esterase Inhibitor
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Caballero T, Farkas H, Bouillet L et al. International consensus and practical guidelines on the gynecologic and obstetric management of female patients with hereditary angioedema caused by C1 inhibitor deficiency. J Allergy Clin Immunol. 2012;129:308-20. PMID: 22197274
2. Maurer M, Magerl M, Ansotegui I et al. The international WAO/EAACI guideline for the management of hereditary angioedema-The 2017 revision and update. Allergy. 2018;73:1575-96. PMID: 29318628
3. Czaller I, Visy B, Csuka D et al. The natural history of hereditary angioedema and the impact of treatment with human C1-inhibitor concentrate during pregnancy: a long-term survey. Eur J Obstet Gynecol Reprod Biol. 2010;152:44-9. PMID: 20541309
4. Martinez-Saguer I, Rusicke E, Aygoren-Pursun E et al. Characterization of acute hereditary angioedema attacks during pregnancy and breast-feeding and their treatment with C1 inhibitor concentrate. Am J Obstet Gynecol. 2010;203:131.e1-7. PMID: 20471627
5. Farkas H, Csuka D, Toth F et al. Successful pregnancy outcome after treatment with C1-inhibitor concentrate in a patient with hereditary angioedema and a history of four miscarriages. Eur J Obstet Gynecol Reprod Biol. 2012;165:366-7. PMID: 22884590
6. Baccioglu A, Kalpaklioglu AF. Successful pregnancy outcome after treatment with C1-inhibitor concentrate in a patient with hereditary angioedema. Allergy Eur J Allergy Clin Immunol. 2014;69:493-4. Abstract.
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
