Is Acenocoumarol Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Acenocoumarol? Is Acenocoumarol safe for nursing mother and child? Does Acenocoumarol extracts into breast milk? Does Acenocoumarol has any long term or short term side effects on infants? Can Acenocoumarol influence milk supply or can Acenocoumarol decrease milk supply in lactating mothers?

Its high plasma protein-binding capacity would explain the very low excretion observed into breast milk (Houwert-de Jong 1981, Nava 2004). No clinical side-effects and/or blood test disarrangements were observed in infants whose mothers were treated with acenocoumarol (Houwert-de Jong 1981, Fondevila 1989).

Acenocoumarol is not approved for marketing in the United States by the U.S. Food and Drug Administration, but is available in Canada and other countries. Because of the low levels of acenocoumarol in breastmilk, amounts ingested by the infant are small. No changes in coagulation measurements or adverse reactions in breastfed infants have been reported from maternal acenocoumarol use during lactation. There is a consensus that maternal acenocoumarol therapy during breastfeeding poses little risk to the breastfed infant.[1][2][3][4][5][6] No special precautions are necessary.

Nineteen infants were breastfed (extent not stated) while their mothers were anticoagulated with acenocoumarol immediately postpartum. Despite not receiving prophylactic vitamin K at birth, none of the infants had abnormal blood clotting as measured by the Thrombotest after at least 5 days of maternal therapy.[1] Seven infants were exclusively breastfed by mothers who were receiving long-term anticoagulation with acenocoumarol for thromboprophylaxis following heart valve replacement. All women were therapeutically anticoagulated and receiving an average of 21 mg of acenocoumarol per week (range 12 to 45 mg per week). Each infant received 1 mg of vitamin K prophylactically at birth and had their prothrombin time measured after at least 7 days of breastfeeding. The prothrombin times of the infants was not different from those of a control group of 42 breastfed infants whose mothers were not anticoagulated. No instances of bleeding were reported.[2]