Is Acenocoumarol compatible with breastfeeding? Do we have alternatives for Acenocoumarol?


October 9, 2016 (Very Low Risk)

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).


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

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.


  • Acenocoumarin
  • Nicoumalone


  • νικουμαλόνη (Greek)
  • أسينوكومارول (Arabic)
  • Аценокумарол (Cyrillic)
  • 醋硝香豆素 (Chinese)
  • アセノクマロール (Japanese)
  • C19H15NO6 (Molecular formula)


  1. Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO; American College of Chest Physicians. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012Abstract Full text (link to original source) Full text (in our servers)
  2. Middeldorp S. How I treat pregnancy-related venous thromboembolism. Blood. 2011Abstract Full text (link to original source) Full text (in our servers)
  3. Nava LE, Gómez AB, González VM. [Plasma and milk concentrations of acenocoumarin in breast-feeding women during post partum]. Ginecol Obstet Mex. 2004Abstract
  4. Bates SM, Ginsberg JS. Anticoagulants in pregnancy: fetal effects. Baillieres Clin Obstet Gynaecol. 1997Abstract
  5. Olthof E, de Vries TW. [Breast feeding and oral anticoagulants]. Tijdschr Kindergeneeskd. 1993Abstract
  6. Fondevila CG, Meschengieser S, Blanco A, Peñalva L, Lazzari MA. Effect of acenocoumarine on the breast-fed infant. Thromb Res. 1989Abstract
  7. Houwert-de Jong M, Gerards LJ, Tetteroo-Tempelman CA, de Wolff FA. May mothers taking acenocoumarol breast feed their infants? Eur J Clin Pharmacol. 1981Abstract