The Direct Factor Xa Inhibitor Rivaroxaban Passes Into Human Breast Milk
Standard
The Direct Factor Xa Inhibitor Rivaroxaban Passes Into Human Breast Milk. / Wiesen, Martin H J; Blaich, Cornelia; Müller, Carsten; Streichert, Thomas; Pfister, Roman; Michels, Guido.
in: CHEST, Jahrgang 150, Nr. 1, 07.2016, S. e1-4.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - The Direct Factor Xa Inhibitor Rivaroxaban Passes Into Human Breast Milk
AU - Wiesen, Martin H J
AU - Blaich, Cornelia
AU - Müller, Carsten
AU - Streichert, Thomas
AU - Pfister, Roman
AU - Michels, Guido
N1 - Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
PY - 2016/7
Y1 - 2016/7
N2 - Thromboembolic disorders frequently require antithrombotic treatment during pregnancy and lactation. Vitamin K antagonists and heparins are the treatment options of choice in breastfeeding women. Factors including the route of administration, discomfort during treatment, and fetal and neonatal safety affect women's choices about anticoagulant therapy. Direct-acting oral anticoagulants (DOACs) have emerged as alternatives to these agents and may offer advantages compared with vitamin K antagonists. As breastfeeding women were excluded from clinical trials evaluating DOACs, no safety and efficacy data are available for these special patients and, crucially, estimates for infant exposure are lacking. Therefore, the manufacturer recommends against using DOACs during the lactation period. We present the case of a patient who stopped breastfeeding owing to a diagnosis of postpartum cardiomyopathy. Anticoagulation with enoxaparin that commenced after the diagnosis of postpartum pulmonary embolism was switched to rivaroxaban. At that time, breast milk samples were collected and rivaroxaban concentrations were determined by liquid chromatography tandem-mass spectrometry. Rivaroxaban appears in human breast milk in comparatively small amounts; its safety has not been determined.
AB - Thromboembolic disorders frequently require antithrombotic treatment during pregnancy and lactation. Vitamin K antagonists and heparins are the treatment options of choice in breastfeeding women. Factors including the route of administration, discomfort during treatment, and fetal and neonatal safety affect women's choices about anticoagulant therapy. Direct-acting oral anticoagulants (DOACs) have emerged as alternatives to these agents and may offer advantages compared with vitamin K antagonists. As breastfeeding women were excluded from clinical trials evaluating DOACs, no safety and efficacy data are available for these special patients and, crucially, estimates for infant exposure are lacking. Therefore, the manufacturer recommends against using DOACs during the lactation period. We present the case of a patient who stopped breastfeeding owing to a diagnosis of postpartum cardiomyopathy. Anticoagulation with enoxaparin that commenced after the diagnosis of postpartum pulmonary embolism was switched to rivaroxaban. At that time, breast milk samples were collected and rivaroxaban concentrations were determined by liquid chromatography tandem-mass spectrometry. Rivaroxaban appears in human breast milk in comparatively small amounts; its safety has not been determined.
KW - Journal Article
U2 - 10.1016/j.chest.2016.01.021
DO - 10.1016/j.chest.2016.01.021
M3 - SCORING: Journal article
C2 - 27396794
VL - 150
SP - e1-4
JO - CHEST
JF - CHEST
SN - 0012-3692
IS - 1
ER -
