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Trying to get breastfeeding women out of the pharmaceutical orphanage

Pediatric Research (2024)Cite this article

In this issue of the journal, Bertrand et al. report their findings on the measurement of Remdesivir and its active metabolite GS-441524 in 17 human milk samples from 4 lactating mothers taking Remdesivir in the commonly recommended dose for coronavirus disease 2019 (COVID-19).1 Based on the analysis of these samples, collected at intervals ranging from 4 h to 61 days after Remdesivir administration, using well-described and appropriate methodology, they found that the estimated relative infant dose (RID) of Remdesivir was <1% and the estimated RID of GS-441524 was <5%. These percentages are well below the generally accepted 10% cut-off for presumed safety in infants. The authors consequently conclude that exposure to Remdesivir in breastfed infants is negligible and of little clinical concern.

Limitations to this work, also acknowledged by the authors themselves, are the small number of women and milk samples included in the analysis, and the variable and sometimes long or even unknown intervals between Remdesivir administration and collection of the milk samples. In spite of these limitations, these findings still provide valuable information on the safety of Remdesivir during lactation, information that is unfortunately lacking for many other medications.

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Authors and Affiliations

  1. Division of Neonatology, Department of Paediatrics, Radboud University Medical Center Amalia Children’s Hospital, Nijmegen, the Netherlands

    Mathijs Binkhorst & Marije Hogeveen

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  1. Mathijs Binkhorst
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  2. Marije Hogeveen
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Correspondence to Marije Hogeveen.

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Binkhorst, M., Hogeveen, M. Trying to get breastfeeding women out of the pharmaceutical orphanage. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03164-w

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