Last update: Aug. 29, 2021

Dalteparin Sodium

Very Low Risk for breastfeeding


Safe. Compatible.
Minimal risk for breastfeeding and infant.

Low-molecular-weight heparin.
Indicated in the treatment and prevention of arterial, venous or pulmonary thromboembolism and in acute coronary syndrome.
Authorized use in neonates and infants.
Subcutaneous or intravenous administration.

It is excreted in breast milk in a clinically non-significant amount (Richter 2001, Harenberg 1987).
No problems have been observed in infants of mothers treated with dalteparin (Richter 2001, Lindhoff 2000).

The high molecular weight of standard or unfractionated heparin and also of low molecular weight heparins makes their passage into breast milk in clinically significant amounts highly unlikely.

In addition, heparins are inactivated in the gastrointestinal tract, not being absorbed (practically zero oral bioavailability), which prevents the passage into plasma of the infant from ingested breast milk.

The risk of heparin-induced thrombocytopenia and osteoporosis is lower with low molecular weight heparins (Fuller 2013, Middeldorp 2011, Rath 2010).

The manufacturer, various medical societies, experts, and expert consensus consider the use of this medication safe during breastfeeding (Hale, Lactmed, Bates 2018 and 1997, Noviani 2016, Briggs 2015, Schaefer 2015, Rowe 2013, Fuller 2013, Yurdakök 2012, Rath 2010).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Dalteparin Sodium is also known as


Dalteparin Sodium in other languages or writings:

Group

Dalteparin Sodium belongs to this group or family:

Tradenames

Main tradenames from several countries containing Dalteparin Sodium in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 6.000 (5.600 - 6.400) daltons
VD 0,04 - 0,06 l/Kg
Tmax 4 hours
T1/2 3 - 4 hours
M/P ratio 0,03 - 0,2 -
Theoretical Dose 5,5(ui) mg/Kg/d
Relative Dose 1,3 %
Ped.Relat.Dose 2,8 %

References

  1. Bates SM, Rajasekhar A, Middeldorp S, McLintock C, Rodger MA, James AH, Vazquez SR, Greer IA, Riva JJ, Bhatt M, Schwab N, Barrett D, LaHaye A, Rochwerg B. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy. Blood Adv. 2018 Nov 27;2(22):3317-3359. Abstract Full text (link to original source)
  2. Noviani M, Wasserman S, Clowse ME. Breastfeeding in mothers with systemic lupus erythematosus. Lupus. 2016 Aug;25(9):973-9. Abstract
  3. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  4. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  5. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  6. Fuller KP, Turner G, Polavarapu S, Prabulos AM. Guidelines for use of anticoagulation in pregnancy. Clin Lab Med. 2013 Abstract
  7. Yurdakök M. Fetal and neonatal effects of anticoagulants used in pregnancy: a review. Turk J Pediatr. 2012 Abstract
  8. Middeldorp S. How I treat pregnancy-related venous thromboembolism. Blood. 2011 Abstract Full text (link to original source) Full text (in our servers)
  9. Rath W. [Thromboprophylaxis during pregnancy and the puerperium: highlights from current guidelines]. Z Geburtshilfe Neonatol. 2010 Abstract
  10. Richter C, Sitzmann J, Lang P, Weitzel H, Huch A, Huch R. Excretion of low molecular weight heparin in human milk. Br J Clin Pharmacol. 2001 Abstract Full text (link to original source) Full text (in our servers)
  11. Lindhoff-Last E, Willeke A, Thalhammer C, Nowak G, Bauersachs R. Hirudin treatment in a breastfeeding woman. Lancet. 2000 Feb 5;355(9202):467-8. Abstract
  12. Bates SM, Ginsberg JS. Anticoagulants in pregnancy: fetal effects. Baillieres Clin Obstet Gynaecol. 1997 Abstract
  13. Kandrotas RJ. Heparin pharmacokinetics and pharmacodynamics. Clin Pharmacokinet. 1992 Abstract
  14. Harenberg J, Leber G, Zimmermann R, Schmidt W. [Prevention of thromboembolism with low-molecular weight heparin in pregnancy]. Geburtshilfe Frauenheilkd. 1987 Abstract
  15. Estes JW. Clinical pharmacokinetics of heparin. Clin Pharmacokinet. 1980 Abstract
  16. Hale TW. Hale's Medications & Mothers' Milk. [Internet]. Springer Publishing Company; 1991-. Available from: https://www.halesmeds.com None
  17. LactMed. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ None Full text (link to original source)

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