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Indicated in the treatment and prevention of arterial, venous or pulmonary thromboembolism and in acute coronary syndrome.
Authorized use in neonates and infants.
Intravenous, intraarterial or subcutaneous administration.
At the date of the last update, there was no available published data on its excretion in breast milk.
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 (Pfizer2016); manufacturers claim that it is not excreted in breast milk (AEMPS 2017, Hospira 2014).
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 (Pfizer2016).
There has been virtually no excretion in breast milk of other lower molecular weight heparins such as dalteparin (Richter 2001). There is absence of anticoagulant activity in plasma of infants breastfed by mothers treated with enoxaparin (Guillonneau 1996).
The risk of heparin-induced thrombocytopenia and osteoporosis is lower with low molecular weight heparins (Fuller 2013, Middeldorp 2011, Rath 2010).
Various medical societies, experts, and expert consensus consider the use of this medication safe during breastfeeding (Hale, Lactmed, Bates 2018 and 1997, Briggs 2015, Schaefer 2015, Rowe 2013, Fuller 2013, Yurdakök 2012, Rath 2010).
WHO 2002 Essential Medicines List: compatible with breastfeeding (WHO 2002).