Bevacizumab

The Basics

What is Bevacizumab?

Used to treat a number of types of cancers and a specific eye disease.

Brand names for Bevacizumab

Avastin

How Bevacizumab is classified

Angiogenesis Inhibitors, Antibodies – Monoclonal, Antineoplastic Agents

Bevacizumab During Pregnancy

Bevacizumab 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 Bevacizumab while pregnant

N/A

Taking Bevacizumab While Breastfeeding

What are recommendations for lactation if you're taking Bevacizumab?

No information is available on the intravenous use of bevacizumab during breastfeeding. Because bevacizumab is a large protein molecule with a molecular weight of about 149,000, 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.[1] Until more data become available, intravenous bevacizumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. The manufacturer recommends that breastfeeding be discontinued during bevacizumab therapy and for 6 months following the last dose. Several infants have been breastfed, apparently without noticeable harm, following maternal intravitreal bevacizumab injections. Bevacizumab was undetectable in the milk of one mother, but vascular endothelial growth factor (VEGF) levels in breastmilk were suppressed following the injection. Because the breast and neonatal intestine have VEGF receptors, some authors recommend use of intravitreal ranibizumab, which does not appear to depress milk VEGF levels.[2]

Maternal / infant drug levels

No information is available on the intravenous use of bevacizumab during breastfeeding. Because bevacizumab is a large protein molecule with a molecular weight of about 149,000, 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.[1] Until more data become available, intravenous bevacizumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. The manufacturer recommends that breastfeeding be discontinued during bevacizumab therapy and for 6 months following the last dose. Several infants have been breastfed, apparently without noticeable harm, following maternal intravitreal bevacizumab injections. Bevacizumab was undetectable in the milk of one mother, but vascular endothelial growth factor (VEGF) levels in breastmilk were suppressed following the injection. Because the breast and neonatal intestine have VEGF receptors, some authors recommend use of intravitreal ranibizumab, which does not appear to depress milk VEGF levels.[2]

Possible effects of Bevacizumab on milk supply

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

Possible alternatives to Bevacizumab

(Intravitreal) Ranibizumab.