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

Alteplase

December 19, 2013 (Very Low Risk)

Synthetic recombinant protein formed by a sequence of amino acids that are identical to Human Tissue Plasminogen Activator (t-PA) which is found in colostrum and mature milk.

A rapid metabolic rate and high molecular weight explains a less than probable excretion into breast milk. Even more, protein structure would impede gut absorption in the child with exception of the first post-partum week.

Alternatives

We do not have alternatives for Alteplase 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.

Drug trade names

References

  1. Heegaard CW, Larsen LB, Rasmussen LK, Højberg KE, Petersen TE, Andreasen PA. Plasminogen activation system in human milk. J Pediatr Gastroenterol Nutr. 1997Abstract
  2. Tanswell P, Seifried E, Su PC, Feuerer W, Rijken DC. Pharmacokinetics and systemic effects of tissue-type plasminogen activator in normal subjects. Clin Pharmacol Ther. 1989Abstract
  3. Marshall JM, Rees MC, Cederholm-Williams SA. Identification of t-PA as the major active plasminogen activator in human milk. Thromb Haemost. 1986Abstract