Безопасно. Совместимый. Минимальный риск для грудного вскармливания и ребёнка.
увеит.
Он выводится в грудном молоке в клинически незначительных количествах (Matro 2018, Fritzsche 2012, Ben-Horn 2010), и у младенцев не наблюдалось никаких проблем, чьи матери (Matro 2018, Dall'ara 2016, Julsgaard 2013, Fritzsche 2012, Mishkin 2006, Mahadevan 2006, Vesga 2005). Уровни в плазме у этих детей были очень низкими (Julsgaard 2013, Fritzsche 2012).
Из -за своей белковой природы он инактивируется в желудочно -кишечном тракте без поглощения (практически нулевой оральной биодоступности) и это препятствует или предотвращает его проход в плазму младенца от проглощенного грудного молока (Lactmed, rademaker 2018, Götestam 2016 , Witzel 2014, Butler 2014, Mervic 2014), за исключением недоношенных детей и в течение непосредственного неонатального периода, когда может быть проницаемость кишечника (Sammaritano 2020).
может быть целесообразно избежать его использования в первой послеродовой неделе, так как проход значительного количества IgG в молоко может произойти в первые 3-4 дня после рода. Случай ранней врожденной нейтропении был опубликован у новорожденного, мать которого принимала адалимумаб из -за болезни Крона и изониазида для туберкулеза (Van Den Broek 2018).
Не было обнаружено проблем у детей, чьи матери получали другие подобные моноклональные антитела, такие как белимумаб, бевацизумаб, инфликсимаб, ритуксимаб, тоцилизумаб, или утекинумаб (Bar-gil 2021, Lahue 2020, Saito 2020, 2019 и 2018, Klenske 2019, Mugheddu 2019, Krysko 2019, Matro 2018, Bragnes 2017, Hyrich 2014, Danve 2014).
Производитель (Amgen 2017, EMA 2010) считает, что использование этого лекарства безопасным во время грудного вскармливания. Скорее всего, будет безопасным (Hale, Owczarek 2020, Sammaritano 2020 Y 2014, Lamb 2019, Mahadevan 2019 Y 2013, Picardo 2019, Amin 2018, Briggs 2015, Nguyen 2016, Flint 2016, McConnell 2016, Gotestam 2016, Huang 2016 Y 2014, Grunewald 2015, Damas 2015, Van der Woude 2015 Y 2010, Nielsen 2014, Witzel 2014, Butler 2014, Schulze 2014, Yarur 2013, Bae 2012, Fischer 2010).
| Наименование | Значение | Ед.изм. |
|---|---|---|
| Tmax | 131 | час |
| T½ | 360 (240 - 480) | час |
| БПП | 0 | % |
| Молекулярная масса | 148.000 | Да |
| ОР | 0.07 - 0.09 | л/кг |
| Относительная доза | 0.7 | % |
| Связывание с белками | 0 | % |
| Соотношение М/П | 0.01 | - |
| Теоретическая доза | 0.00465 | мг/кг/сут |
См. ниже информацию об этих сопутствующих препаратах:
Материнский ревматоидный артрит (РА) ◐ Умеренный риск
Материнское воспалительное заболевание кишечника (ВЗК) ◐ Умеренный риск
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