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Is there any information on the use of the new migraine e medication, Emgality (galcanezumab-gnlm) while nursing? It is a CGRP antagonist recently approved for use for migraine management manufactured by Eli Lilly. Any information would be much appreciated.
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I also have a mom who has been taking Emgality during her pregnancy for vertigo. Can she breastfeed after delivery? -
Pfoise:
Galcanezumab-gnlm (Emgality) is a humanized IgG4 monoclonal antibody specific for calcitonin-gene related peptide (CGRP) ligand. It is a humanized monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor. As an IgG4, levels in milk are believed to be higher than those of IgG1 monoclonal antibodies. At this time we do not know the rate of transfer of this specific IgG4 monoclonal antibody, but some is likely to penetrate into human milk.
That said, plasma levels in the newborn are likely to be significant, because of its transfer in the third trimester.
As an IgG, it is unlikely to survive the proteases in the GI tract and little is believed to be absorbed after delivery. I think the risk to the infant is low, but is yet to be determined.
Tom Hale Ph.D.Comment
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Dr. Hale, do you have thoughts on Emgality for my 40lb, 3 year 6 month old nursling? We nurse once per day for about 5 minutes. Thanks!Comment
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Rellia:
I don't think there is much if any risk at all for this 3.5 year old infant. I doubt he/she gets enough milk to provide much of any dose at all.
I wouldn't worry about it.
Tom Hale Ph.D.
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