Is Rivaroxaban Safe in Breastfeeding
Question
I am a breastfeeding mother and i want to know if it is safe to use Rivaroxaban? Is Rivaroxaban safe for nursing mother and child? Does Rivaroxaban extracts into breast milk? Does Rivaroxaban has any long term or short term side effects on infants? Can Rivaroxaban influence milk supply or can Rivaroxaban decrease milk supply in lactating mothers?
Rivaroxaban lactation summary
- DrLact safety Score for Rivaroxaban is 3 out of 8 which is considered Low Risk as per our analyses.
- A safety Score of 3 indicates that usage of Rivaroxaban may cause some minor side effects in breastfed baby.
- Our study of different scientific research indicates that Rivaroxaban may cause moderate to no side effects in lactating mother.
- Most of scientific studies and research papers declaring usage of Rivaroxaban low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
- While using Rivaroxaban We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
- Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.
Answer by Dr. Ru: About Rivaroxaban usage in lactation
Direct factor Xa inhibitor, indicated in the prevention of thromboembolism.Administered orally every 12 to 24 hours. From a single published case study we know that it is excreted in breast milk in clinically insignificant amounts (Wiesen 2016); the newborn was not breastfed. Until there is more published data on this drug in relation to breastfeeding, safer known alternatives may be preferable, especially during the neonatal period and in case of prematurity.
Answer by DrLact: About Rivaroxaban usage in lactation
Limited information indicates that a maternal dose of rivaroxaban of 30 mg daily produces low levels in milk. If rivaroxaban is required by the mother, it is not a reason to discontinue breastfeeding. However, until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.[1][2]
Alternate Drugs
Rivaroxaban(Low Risk)
Abciximab(Low Risk)
Acenocoumarol(Safe)
Warfarin(Safe)
Lepirudin(Low Risk)
Heparin(Safe)
Enoxaparin(Safe)
Dalteparin(Safe)
Fondaparinux(Safe)
Desirudin(Unsafe)