Ranibizumab

The Basics

What is Ranibizumab?

Used to treat age-related macular degeneration.

Brand names for Ranibizumab

Lucentis

How Ranibizumab is classified

Antibodies – Monoclonal, Angiogenesis Inhibitors

Ranibizumab During Pregnancy

Ranibizumab 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 Ranibizumab while pregnant

N/A

Taking Ranibizumab While Breastfeeding

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

Because ranibizumab is a large protein molecule with a molecular weight of 48,000, 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. One infant was breastfed, apparently without noticeable harm, following maternal intravitreal ranibizumab injections. Vascular endothelial growth factor (VEGF) levels in breastmilk were not changed following the injection. Because the breast and neonatal intestine have VEGF receptors, some authors recommend use of intravitreal ranibizumab over bevacizumab, which does appear to depress milk VEGF levels.[1] Ranibizumab is a human immunoglobulin G1 (IgG1) kappa antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[2][3] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%. Specific IgG subclasses decreased by different amounts, with IgG1 activity decreasing by about 37%.[4] None of the studies measured IgG activity.

Maternal / infant drug levels

Because ranibizumab is a large protein molecule with a molecular weight of 48,000, 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. One infant was breastfed, apparently without noticeable harm, following maternal intravitreal ranibizumab injections. Vascular endothelial growth factor (VEGF) levels in breastmilk were not changed following the injection. Because the breast and neonatal intestine have VEGF receptors, some authors recommend use of intravitreal ranibizumab over bevacizumab, which does appear to depress milk VEGF levels.[1] Ranibizumab is a human immunoglobulin G1 (IgG1) kappa antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[2][3] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%. Specific IgG subclasses decreased by different amounts, with IgG1 activity decreasing by about 37%.[4] None of the studies measured IgG activity.

Possible effects of Ranibizumab on milk supply

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

Possible alternatives to Ranibizumab

(Intravitreal) Bevacizumab.