Can you take aflibercept while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
This record refers to the use of intravitreal aflibercept. Aflibercept inhibits vascular endothelial growth factor (VEGF). Aflibercept is a large protein molecule with a molecular weight of 115,000 Daltons. Aflibercept appeared in breastmilk in small amounts in only one of four days after intravitreal injection in one mother. Absorption by the infant is unlikely because it is probably partly destroyed in the infant's gastrointestinal tract and poorly absorbed orally, so systemic effects in infants are not expected. Aflibercept is approved for intravitreal injection in preterm infants with retinopathy of prematurity. The risk to nursing infants appears to be low. Since VEGF is present in human milk and is thought to help in maturation of the infant’s gastrointestinal tract, concern has been raised about the maternal use of VEGF inhibitors during breastfeeding. However, the typical alternative to breastmilk is infant formula, which contains no VEGF. Some sources consider ranibizumab to be preferable to aflibercept in nursing mothers because of its lower systemic exposure after intravitreal injection.
Quoted from Aflibercept — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised November 15, 2025.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of aflibercept. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much aflibercept gets into breastmilk
Maternal Levels. A woman with diabetic macular edema was given intravitreal aflibercept 2 mg one week postpartum. She was not breastfeeding her infant. Milk samples were obtained before the injection and on days 1 to 4 after the injection. Aflibercept was detected only on day 4 in a concentration of 10.9 mcg/L.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Relevant published information was not found as of the revision date.
Effects on milk supply
A woman with diabetic macular edema was given intravitreal aflibercept 2 mg one week postpartum. She was not breastfeeding her infant. Milk samples were obtained before the injection and on days 1 to 4 after the injection. VEGF levels were reduced from 10.6 mcg/L at baseline to 4.9 mcg/L on day 1, where it remained for the next 3 days.
Frequently asked questions
Can you take aflibercept while breastfeeding?
This record refers to the use of intravitreal aflibercept. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
What can I take instead of aflibercept while breastfeeding?
LactMed lists Bevacizumab, Ranibizumab as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does aflibercept pass into breastmilk?
LactMed's measured drug levels for aflibercept are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking aflibercept?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on aflibercept
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.