Can you take imiglucerase 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.
Imiglucerase is a synthetic form of beta-glucocerebrosidase, which is a normal component of human milk. After therapeutic use of imiglucerase, breastmilk levels are lower than those of normal mothers. Additionally, absorption by the infant is unlikely because it is probably destroyed in the infant’s gastrointestinal tract. International panels of clinicians that treat Gaucher’s disease recommend breastfeeding with enzyme replacement therapy such as imiglucerase. Consider limiting the duration of breastfeeding to about 6 months to avoid excessive bone loss in the nursing mother.[3–5]
Quoted from Imiglucerase — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised May 15, 2025.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of imiglucerase. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Alglucerase
- Taliglucerase Alfa
How much imiglucerase gets into breastmilk
Maternal Levels. A woman on long-term imiglucerase therapy for Gaucher’s disease was monitored after her usual dose of 60 units/kg intravenously every 2 weeks. At 6 months postpartum, milk samples were obtained and measured for beta-glucocerebrosidase activity, using milk from 10 mothers with galactorrhea as controls. The highest enzyme activity in milk was 16 nanomoles/hour/mL at 1 hour after the end of the infusion. Enzymatic activity decreased to the preinfusion level (0.008 nanomoles/hour/mL) in the samples of breastmilk taken about 5 hours after the end of the infusion and remained low for all samples taken over the first 24 hours after the dose. Breastmilk beta-glucocerebrosidase activity of the control subjects ranged from 0.067 to 0.214 nanomoles/hour/mL.
A woman with type 1 Gaucher’s disease was exclusively breastfeeding her infant postpartum re-initiated intravenous imiglucerase 30 units/kg over 2 hours every 2 weeks at 1 month postpartum. Milk beta-glucocerebrosidase activity was measured at the time of her first postpartum dose, milk. Before the infusion activity was 2 nanomoles/hour/mL. Milk levels were 3 and 4 nanomoles/hour/mL immediately after and 30 minutes after the infusion, respectively. These values were much lower than the level of 42 nanomoles/hour/mL measured in the milk of a control mother without Gaucher’s disease.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
A woman received imiglucerase 30 units/kg every 2 weeks during pregnancy and for 3 months while breastfeeding. The dose was then increased to 60 units/kg every 2 weeks because of disease progression, and she continued breastfeeding until the infant was 1 year old.
A woman receiving long-term therapy with imiglucerase 60 units/kg intravenously every 2 weeks became pregnant twice during therapy and breastfed both infants (extent not stated). Both infants developed normally during the observation periods of 13 and 33 months.
A woman with type 1 Gaucher’s disease was exclusively breastfeeding her infant postpartum re-initiated intravenous imiglucerase 30 units/kg every 2 weeks beginning at 1 month postpartum. The infant was breastfed for about 9 months postpartum and was reportedly healthy when followed up to 3 years of age.
A woman with Gaucher’s disease received imiglucerase 1800 units (30 units/kg) every 2 weeks during pregnancy and postpartum. Her infant was breastfed (extent not stated) and was followed by a pediatrician who determined that development was normal over 2 years.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take imiglucerase while breastfeeding?
Imiglucerase is a synthetic form of beta-glucocerebrosidase, which is a normal component of human milk. 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 imiglucerase while breastfeeding?
LactMed lists Alglucerase, Taliglucerase Alfa 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 imiglucerase pass into breastmilk?
LactMed's measured drug levels for imiglucerase are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking imiglucerase?
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 imiglucerase
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.