The question of whether an individual taking biologic medication can donate blood requires a nuanced answer based on patient safety. In most cases, taking a biologic results in a temporary or permanent deferral from donation. The specific rules depend on the drug’s name, its mechanism of action, and the underlying medical condition being treated. Blood donation centers have strict eligibility criteria designed to protect both the donor and the recipient.
Understanding Biologics
Biologics are a specialized class of medications derived from living sources, such as human, animal, or microorganism cells, distinguishing them from chemically synthesized small-molecule drugs. Biologics are large, complex molecules, often proteins, manufactured using advanced biotechnology. These drugs are designed to target specific components of the immune system with high precision. They work by blocking proteins like tumor necrosis factor (TNF) or interfering with cellular pathways that drive inflammation. Biologics are commonly used to treat chronic conditions like rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and psoriasis.
Blood Donation Eligibility and Deferral Rules
The use of biologic medications generally results in a mandatory deferral from donating whole blood, platelets, or plasma. The length of this deferral is not uniform and is determined by the specific drug’s half-life. This half-life measures the time it takes for the drug concentration to be reduced by half in the body. Different biologics require different waiting periods to ensure the medication is cleared from the bloodstream before donation.
For many widely used tumor necrosis factor (TNF) inhibitors, such as adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade), the required waiting period is three months after the last dose. Other immunosuppressive medications have varying deferral times; for instance, the oral drug upadacitinib (Rinvoq) requires a one-month waiting period. Medications used to treat severe conditions may carry a much longer deferral, such as teriflunomide (Aubagio), which requires a two-year waiting period due to its extended presence in the body.
The underlying medical condition being treated can also make a person ineligible to donate, regardless of the medication. Many autoimmune diseases, such as severe rheumatoid arthritis or lupus, may disqualify a donor. Since these rules are complex and constantly updated, individuals should consult the specific medication deferral list provided by their local blood center before attempting to donate.
Safety Concerns: Why Biologics Matter to Recipients
The primary rationale for deferral is to prevent the passive transfer of medication residue to the transfusion recipient. Trace amounts of the drug remain in the donated blood product when a person on a biologic donates blood. This is a concern because recipients are often medically fragile or immunocompromised, such as premature infants, cancer patients, or organ transplant recipients.
Even small quantities of a biologic drug can pose a risk to these vulnerable patients. If an immunosuppressive drug is transferred, it could weaken the recipient’s already compromised immune system, increasing susceptibility to severe infection. Another concern is teratogenicity, which is the potential for a drug to cause birth defects.
If blood containing residual medication is transfused to a pregnant woman, certain drug components could harm the developing fetus. Blood centers mandate these deferrals to eliminate the risk of transferring a biologically active compound. This prevents interference with a recipient’s therapy or direct harm.
Other Ways to Contribute: Non-Blood Donations
For individuals who are permanently or temporarily deferred from donating whole blood or blood components, there are several meaningful ways to support the medical community. While the same deferral rules often apply to apheresis donations like platelets and plasma, other avenues for contribution exist. Some individuals ineligible for blood donation may still be able to join the national bone marrow or stem cell registry.
The eligibility rules for the bone marrow registry are different and focus on the health of the potential donor and the severity of their underlying condition. Individuals with well-controlled, mild autoimmune conditions might be accepted. However, those with severe disease or those requiring injectable insulin or certain systemic medications are generally excluded from registering.
People can contribute by volunteering time at local blood drives or blood centers to assist with registration and donor care. Organizing or promoting blood donation events is another way to help increase the supply. This ensures that eligible donors are motivated to give.