Can you take dupilumab 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.
Evidence indicates that dupilumab is acceptable to use during breastfeeding. Because dupilumab is a large protein molecule with a molecular weight of about 147,000 Da, the amount in milk is likely to be very low. It is also likely to be partially destroyed in the infant's gastrointestinal tract and absorption by the infant is probably minimal. Expert opinions consider dupilumab acceptable during breastfeeding. Waiting for at least 2 weeks postpartum to resume therapy may minimize transfer to the infant. Until more data become available, dupilumab should be used with caution while nursing a newborn or preterm infant.
Quoted from Dupilumab — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised January 15, 2025.
How much dupilumab gets into breastmilk
Maternal Levels. A woman began receiving dupilumab 300 mg subcutaneously every 2 weeks starting 2.5 months after delivery. A milk sample 3 days after a dose had a dupilumab concentration of 1.1 mg/L, which was 1.3% of the simultaneous maternal plasma concentration.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
A woman with atopic eczema received dupilumab subcutaneously in a dose of 300 mg every 2 weeks during pregnancy and postpartum. She breastfed her infant (extent not stated) for at least 4 months during which no complications were reported. Seven months after delivery, she became pregnant again and continued dupilumab at the same dose throughout the pregnancy and lactation. No complications were seen during breastfeeding.
Eight women with atopic dermatitis received dupilumab during pregnancy and breastfeeding. Two breastfed for 1 month, one for 7.2 months, one for 8.8 months, one for 10 months, one for 11.5 months, one for 14.5 months, and one for 16.1 months. None of the babies had developed atopic dermatitis at the time of publication and no adverse effects were reported.
A woman in Portugal with long-standing atopic dermatitis began dupilumab therapy (dose not stated) with good results. She became pregnant and continued dupilumab. She delivered a healthy infant and breastfed for 8 months (extent not stated). The breastfed infant had no complications.
A woman with long-standing atopic dermatitis began receiving dupilumab 300 mg every 2 weeks. When she became pregnant 24 months later, she stopped the drug, but had a disease flare in 2 weeks. The drug was restarted and she continued receiving it throughout the pregnancy and postpartum. She breastfed (extent and duration not stated) her infant. At 18 months of age, the infant had no complications.
Investigators in Portugal reported a retrospective study of moderate-to-severe atopic dermatitis treated with dupilumab during pregnancy and breastfeeding in three tertiary medical centers. Two women with atopic dermatitis and allergic rhinitis took dupilumab for 9 and 18 months, respectively, while breastfeeding their infants. The exact dosage and extent of breastfeeding were not specified. The infants showed normal development and weight gain.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take dupilumab while breastfeeding?
Evidence indicates that dupilumab is acceptable to use during breastfeeding. 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.
Does dupilumab pass into breastmilk?
LactMed's measured drug levels for dupilumab are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking dupilumab?
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 dupilumab
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.