Last update: Nov. 9, 2014

Heparin

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

The high molecular weight of both standard or non-fractionated Heparin, and, so-called low molecular weight Heparin makes excretion into breast milk extremely difficult. Dalteparin has been shown not to be excreted into breast milk .

In addition, Heparins are inactivated in the GE tract where they are not absorbed which is reason to have a nil oral bioavailability.

Absence of anti-clotting activity in breastfed infants has been shown after treatment of the mother with Enoxaparin.

Risk of Heparin-induced Thrombocytopenia or Osteoporosis in the mother is lower with low weight Heparins.

Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Alternatives

We do not have alternatives for Heparin since it is relatively safe.

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.

Group

Heparin belongs to this group or family:

Pharmacokinetics

Variable Value Unit
Bioavailability 0 %
Molecular weight 15.000 (5.000 - 30.000) daltons
Protein Binding 95 %
Tmax 0,3 hours
T1/2 1 - 2 hours
M/P ratio 0 -

References

  1. Hospira NZ Limited. Heparin. Data Sheet. 2014 Full text (in our servers)
  2. Ozdemir D, Tam AA, Dirikoc A, Ersoy R, Cakir B. Postpartum osteoporosis and vertebral fractures in two patients treated with enoxaparin during pregnancy. Osteoporos Int. 2014 Abstract
  3. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  4. Fuller KP, Turner G, Polavarapu S, Prabulos AM. Guidelines for use of anticoagulation in pregnancy. Clin Lab Med. 2013 Abstract
  5. Yurdakök M. Fetal and neonatal effects of anticoagulants used in pregnancy: a review. Turk J Pediatr. 2012 Abstract Full text (link to original source) Full text (in our servers)
  6. Middeldorp S. How I treat pregnancy-related venous thromboembolism. Blood. 2011 Abstract Full text (link to original source) Full text (in our servers)
  7. Rath W. [Thromboprophylaxis during pregnancy and the puerperium: highlights from current guidelines]. Z Geburtshilfe Neonatol. 2010 Abstract
  8. AEMPS. Heparina. Ficha técnica. 2009 Full text (in our servers)
  9. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  10. Lindhoff-Last E, Bauersachs R. Heparin-induced thrombocytopenia-alternative anticoagulation in pregnancy and lactation. Semin Thromb Hemost. 2002 Abstract
  11. Wautrecht JC. [Which anticoagulants?]. Rev Med Brux. 2002 Abstract
  12. 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)
  13. Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Arch Intern Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  14. Lindhoff-Last E, Willeke A, Thalhammer C, Nowak G, Bauersachs R. Hirudin treatment in a breastfeeding woman. Lancet. 2000 Abstract
  15. Bates SM, Ginsberg JS. Anticoagulants in pregnancy: fetal effects. Baillieres Clin Obstet Gynaecol. 1997 Abstract
  16. Guillonneau M, de Crepy A, Aufrant C, Hurtaud-Roux MF, Jacqz-Aigrain E. [Breast-feeding is possible in case of maternal treatment with enoxaparin]. Arch Pediatr. 1996 Abstract
  17. Kandrotas RJ. Heparin pharmacokinetics and pharmacodynamics. Clin Pharmacokinet. 1992 Abstract
  18. Wunderer G, Müller G. [Osteoporosis and pre- and postpartal heparin therapy]. Geburtshilfe Frauenheilkd. 1990 Abstract
  19. Ginsberg JS, Hirsh J. Optimum use of anticoagulants in pregnancy. Drugs. 1988 Abstract
  20. Harenberg J, Leber G, Zimmermann R, Schmidt W. [Prevention of thromboembolism with low-molecular weight heparin in pregnancy]. Geburtshilfe Frauenheilkd. 1987 Abstract
  21. Estes JW. Clinical pharmacokinetics of heparin. Clin Pharmacokinet. 1980 Abstract

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