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

Rivaroxaban

December 8, 2017 (Low Risk)

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.

Alternatives

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.

Writings

  • ريفاروكسابان (Arabic)
  • Ривароксабан (Cyrillic)
  • 利伐沙班 (Chinese)
  • リバロキサバン (Japanese)
  • C19H18ClN3O5S (Molecular formula)
  • 5-Chloro-N-({(5S)-2-oxo-3-[4-(3-oxomorpholin-4-yl)phenyl]-1,3-oxazolidin-5-yl}methyl)thiophene-2-carboxamide (Chemical name)
  • Bay-59-7939 (Experimental code/s)
  • B01AF01 (ATC Code/s)

Drug trade names

References

  1. EMA. Rivaroxaban (Xarelto). Drug Summary. 2017 Full text (in our servers)
  2. EMA. Rivaroxabán (Xarelto). Ficha técnica. 2017 Full text (in our servers)
  3. Wiesen MH, Blaich C, Müller C, Streichert T, Pfister R, Michels G. The Direct Factor Xa Inhibitor Rivaroxaban Passes Into Human Breast Milk. Chest. 2016Abstract Full text (link to original source) Full text (in our servers)