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Infliximab is an anti-inflammatory drug. If taken by a woman during pregnancy or breastfeeding, it can pass to the fetus or the child and reduce its immune defenses. Live attenuated vaccines will then have to be staggered in time, warns the National Agency for the Safety of Medicines and Health Products (ANSM)
Infliximab is a medicine prescribed for the treatment of various autoimmune diseases in adults, such as rheumatoid arthritis, Crohn’s disease, psoriasis, etc. Infliximab-based medicines, marketed in France and affected by this recommendation are: Remicade, Remsima, Inflectra, Flixabi, Zessly.
A molecule that passes into the blood and into breast milk
Indeed, when infliximab is taken by a pregnant or breastfeeding woman, the molecule crosses the barrier of the placenta and is found in the blood of the fetus, but also in breast milk.
However, the immune defenses of infants exposed to infliximab during pregnancy or while breastfeeding can be reduced by this molecule. Because of this, there is a risk of infection in these infants.
Follow your pregnancy week by week
Postpone vaccination for live attenuated vaccines
Vaccination with a live attenuated vaccine (such as MMR or BCG vaccines) of these infants should therefore be postponed to 12 months after birth and is not recommended during breastfeeding unless infliximab is undetectable in the infant’s blood. the child. As an indication, the live attenuated vaccines indicated for children under 12 months are BCG, MMR, vaccines against yellow fever, rotavirus or varicella. For information on vaccination schedules for children and infants, see vaccination-info-service.
Talk to your doctor
If you have taken infliximab during your pregnancy or if you are breastfeeding and you are taking infliximab, talk to the doctor who follows your child, so as not to expose him to a risk of infection. Several scenarios will then arise:
- If you received this medicine during your pregnancy, your doctor may need to delay vaccinating your child with a live attenuated vaccine (including MMR and BCG) for 12 months after birth, to ensure that he does not has more infliximab in his system.
- If you are currently taking this medicine and are breastfeeding, it is not recommended to vaccinate your child with a live attenuated vaccine (such as BCG or MMR) unless infliximab is undetectable in their blood. Discuss with your doctor about the benefits of breastfeeding against the risk of exposing the child to diseases prevented by vaccination.
- If your doctor deems it necessary to administer these vaccines earlier or during breast-feeding, he may need to take a blood test from your child to ensure that there is no more infliximab in his organization.
- If the vaccination is postponed, your doctor will issue a temporary vaccination contraindication certificate for your child for medical reasons, in order to allow your child to access community childcare.