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

Warfarin

May 1, 2016 (Very Low Risk)

Coumarin-type anticoagulant drug for the treatment and prophylaxis of thromboembolic disorders.

Warfarin is not detected in breast milk. Not problems have been observed in infants whose mothers were treated. Plasma levels of warfarin in such infants were undetectable.

Even in cases of accidental maternal overdosing, infants did not show any clinical problem and/or coagulation tests were not altered.

American Academy of Pediatrics states that it is a medication usually compatible with breastfeeding.
WHO List of Essential Medicines 2002: compatible with breastfeeding.

Alternatives

We do not have alternatives for Warfarin 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.

Writings

  • βαρφαρίνη (Greek)
  • وارفارين (Arabic)
  • Варфарин (Cyrillic)
  • 워파린 (Korean)
  • 华法林 (Chinese)
  • ワルファリン (Japanese)
  • C19H16O4 (Molecular formula)

Drug trade names

References

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  2. Marshall AL. Diagnosis, treatment, and prevention of venous thromboembolism in pregnancy. Postgrad Med. 2014Abstract
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  4. 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)
  5. Yurdakök M. Fetal and neonatal effects of anticoagulants used in pregnancy: a review. Turk J Pediatr. 2012Abstract Full text (link to original source) Full text (in our servers)
  6. Schindler D, Graham TP. Warfarin Overdose in a Breast-feeding Woman. West J Emerg Med. 2011Abstract
  7. Middeldorp S. How I treat pregnancy-related venous thromboembolism. Blood. 2011Abstract Full text (link to original source) Full text (in our servers)
  8. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  9. Dresang LT, Fontaine P, Leeman L, King VJ. Venous thromboembolism during pregnancy. Am Fam Physician. 2008Abstract
  10. Lindhoff-Last E, Bauersachs R. Heparin-induced thrombocytopenia-alternative anticoagulation in pregnancy and lactation. Semin Thromb Hemost. 2002Abstract
  11. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  12. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
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  14. Greer IA. The special case of venous thromboembolism in pregnancy. Haemostasis. 1998Abstract
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  24. Orme ML, Serlin MJ, Breckenridge A. Thromboembolism in pregnancy. Br Med J. 1979Abstract
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