The Basics
What is Interferon Alfa?
Used in the treatment of chronic hepatitis B and C, melanoma, and hairy cell leukemia.
Brand names for Interferon Alfa
N/A
How Interferon Alfa is classified
Anti-Infective Agents, Antiviral Agents, Antineoplastic Agents
Interferon Alfa During Pregnancy
Interferon Alfa pregnancy category
Category N/ANote 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 Interferon Alfa while pregnant
N/A
Taking Interferon Alfa While Breastfeeding
What are recommendations for lactation if you're taking Interferon Alfa?
Because of the low levels in milk and poor oral absorption by the infant, it is unlikely that interferon use by a nursing mother presents any serious risk to the breastfed infant.[1] Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of the related endogenous interferon-gamma by an average about 10%.[2] For use in treating maternal hepatitis B, no difference exist in infection rates between breastfed and formula-fed infants born to hepatitis B-infected women, as long as the infant receives hepatitis B immune globulin and hepatitis B vaccine at birth. Mothers with hepatitis B are encouraged to breastfeed their infants after their infants receive these preventative measures.[3][4] Hepatitis C is not transmitted through breastmilk[5][6] and breastmilk has been shown to inactivate hepatitis C virus (HCV).[7][8] However, the Centers for Disease Control recommends that mothers with HCV infection should consider abstaining from breastfeeding if their nipples are cracked or bleeding. It is not clear if this warning would apply to mothers who are being treated for hepatitis C. Infants born to mothers with HCV infection should be tested for HCV infection; because maternal antibody is present for the first 18 months of life and before the infant mounts an immunologic response, nucleic acid testing is recommended.[5][6]
Maternal / infant drug levels
Because of the low levels in milk and poor oral absorption by the infant, it is unlikely that interferon use by a nursing mother presents any serious risk to the breastfed infant.[1] Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of the related endogenous interferon-gamma by an average about 10%.[2] For use in treating maternal hepatitis B, no difference exist in infection rates between breastfed and formula-fed infants born to hepatitis B-infected women, as long as the infant receives hepatitis B immune globulin and hepatitis B vaccine at birth. Mothers with hepatitis B are encouraged to breastfeed their infants after their infants receive these preventative measures.[3][4] Hepatitis C is not transmitted through breastmilk[5][6] and breastmilk has been shown to inactivate hepatitis C virus (HCV).[7][8] However, the Centers for Disease Control recommends that mothers with HCV infection should consider abstaining from breastfeeding if their nipples are cracked or bleeding. It is not clear if this warning would apply to mothers who are being treated for hepatitis C. Infants born to mothers with HCV infection should be tested for HCV infection; because maternal antibody is present for the first 18 months of life and before the infant mounts an immunologic response, nucleic acid testing is recommended.[5][6]
Possible effects of Interferon Alfa on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Interferon Alfa
(Hepatitis B) Lamivudine, Tenofovir; (Hepatitis C) Interferon Alfacon-1, Peginterferon Alfa.
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. Balsat M, Etienne M, Elhamri M et al. Successful pregnancies in patients with BCR-ABL-positive leukemias treated with interferon-alpha therapy during the tyrosine kinase inhibitors era. Eur J Haematol. 2018;101:774-80. PMID: 30179268
2. Ewaschuk JB, Unger S, O’Connor DL et al. Effect of pasteurization on selected immune components of donated human breast milk. J Perinatol. 2011;31:593-8. PMID: 21330996
3. Visvanathan K, Dusheiko G, Giles M et al. Managing HBV in pregnancy. Prevention, prophylaxis, treatment and follow-up: Position paper produced by Australian, UK and New Zealand key opinion leaders. Gut. 2016;65:340-50. PMID: 26475631
4. Dionne-Odom J, Tita AT, Silverman NS. #38: Hepatitis B in pregnancy screening, treatment, and prevention of vertical transmission. Am J Obstet Gynecol. 2016;214:6-14. PMID: 26454123
5. Cottrell EB, Chou R, Wasson N et al. Reducing risk for mother-to-infant transmission of hepatitis C virus: A systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;158:109-13. PMID: 23437438
6. Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137. PMID: 26042815
7. Pfaender S, Heyden J, Friesland M et al. Inactivation of hepatitis C virus infectivity by human breast milk. J Infect Dis. 2013;208:1943-52. PMID: 24068703
8. Tovo PA, Calitri C, Scolfaro C et al. Vertically acquired hepatitis C virus infection: Correlates of transmission and disease progression. World J Gastroenterol. 2016;22:1382-92. PMID: 26819507
9. Haggstrom J, Adriansson M, Hybbinette T et al. Two cases of CML treated with alpha-interferon during second and third trimester of pregnancy with analysis of the drug in the new-born immediately postpartum. Eur J Haematol. 1996;57:101-2. Letter. PMID: 8698119
10. Kumar AR, Hale TW, Mock RE. Transfer of interferon alfa into human breast milk. J Hum Lact. 2000;16:226-8. PMID: 11153157
11. Williams JM, Schlesinger PE, Gray AG. Successful treatment of essential thrombocythaemia and recurrent abortion with alpha interferon. Br J Haematol. 1994;88:647-8. PMID: 7819084
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.
