Is Tranexamic Acid compatible with breastfeeding? Do we have alternatives for Tranexamic Acid?

Tranexamic Acid

January 29, 2017 (Very Low Risk)

Anti-fibrinolytic drug that is used on the treatment and prophylaxis of hereditary angioedema, menorrhagia and other hemorrhagic disorders.

It is excreted into breast milk in a non-significant amount: the concentration measured in the milk was 1% of plasma concentration (Verstraeten 1985, WHO 2010, Caballero 2012).
Despite of that low observed concentration, an expert consensus did not recommend its use while breastfeeding (Caballero 2012).

No clinical or developmental issues have been observed in the short and long term among 21 infants whose mothers were treated with it. (Gilad 2014).

Scientific societies and some consensus of experts believe it is compatible the use of Tranexamic acid during breastfeeding (WHO 2010, Bouillet 2015).

Alternatives

We do not have alternatives for Tranexamic Acid 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.

Synonyms

  • Amcha

Writings

  • τρανεξαμικό οξύ (Greek)
  • حمض ترانيكساميك (Arabic)
  • Транексамовая Кислота (Cyrillic)
  • 氨甲环酸 (Chinese)
  • トラネキサム酸 (Japanese)
  • C8H15NO2 (Molecular formula)

References

  1. Bouillet L, Lehmann A, Gompel A, Boccon-Gibod I, Launay D, Fain O; CREAK.. [Hereditary angiœdema treatments: Recommendations from the French national center for angiœdema (Bordeaux consensus 2014)]. Presse Med. 2015Abstract
  2. Gilad O, Merlob P, Stahl B, Klinger G. Outcome following tranexamic acid exposure during breastfeeding. Breastfeed Med. 2014Abstract
  3. Caballero T, Farkas H, Bouillet L, Bowen T, Gompel A, Fagerberg C, Bjökander J, Bork K, Bygum A, Cicardi M, de Carolis C, Frank M, Gooi JH, Longhurst H, Martínez-Saguer I, Nielsen EW, Obtulowitz K, Perricone R, Prior N; C-1-INH Deficiency Working Group.. International consensus and practical guidelines on the gynecologic and obstetric management of female patients with hereditary angioedema caused by C1 inhibitor deficiency. J Allergy Clin Immunol. 2012Abstract Full text (link to original source) Full text (in our servers)
  4. Pfizer. Tranexamic acid (Cyklokapron). Drug Summary. 2011 Full text (in our servers)
  5. AEMPS. Ácido Tranexámico (Amchafibrin) Ficha técnica. 2010 Full text (in our servers)
  6. Shakur H, Elbourne D, Gülmezoglu M, Alfirevic Z, Ronsmans C, Allen E, Roberts I. The WOMAN Trial (World Maternal Antifibrinolytic Trial): tranexamic acid for the treatment of postpartum haemorrhage: an international randomised, double blind placebo controlled trial. Trials. 2010Abstract
  7. WHO. 18th Expert Committee on the Selection and Use of Essential Medicines. Tranexamic acid. WHO EML. 2010 Full text (link to original source) Full text (in our servers)
  8. Verstraete M. Clinical application of inhibitors of fibrinolysis. Drugs. 1985Abstract
  9. Pilbrant A, Schannong M, Vessman J. Pharmacokinetics and bioavailability of tranexamic acid. Eur J Clin Pharmacol. 1981Abstract