Of course, there is no current information on Hepsera, so I will have to do
a theoretical evaluation.
Since Hepsera is a nucleotide analog, it probably has a very large molecular
size which would mean only a very small amount would get through to the
breast milk.
Secondly, the mothers plasma level after an oral dose would be in the
nanograms level (18 ng.mL), which according to Tom Hale ( I just met him
personally), when the mothers drug levels are at nanogram levels, the mother
should be able to safely breastfeed.
The peak level occurs at about 2 hours, so the mother of a two year old
should certainly be able to avoid that time period, resulting in even LOWER
possible breast milk levels.
This is the best I can do from what is known about the pharmacokinetics of
this drug.
Frank J. Nice, DPA, CPHP

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