Universität zu Köln

Wiesen, Martin H. J., Blaich, Cornelia, Mueller, Carsten, Streichert, Thomas, Pfister, Roman and Michels, Guido (2016). The Direct Factor Xa Inhibitor Rivaroxaban Passes Into Human Breast Milk. Chest, 150 (1). S. E1 - 4. GLENVIEW: AMER COLL CHEST PHYSICIANS. ISSN 0012-3692

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Abstract

Thromboembolic disorders frequently require antithrombotic treatment during pregnancy and lactation. Vitamin K antagonists and heparins are the treatment options of choice in breast-feeding women. Factors including the route of administration, discomfort during treatment, and fetal and neonatal safety affect women's choices about anticoagulant therapy. Direct-acting oral anticoagulants (DOACs) have emerged as alternatives to these agents and may offer advantages compared with vitamin K antagonists. As breastfeeding women were excluded from clinical trials evaluating DOACs, no safety and efficacy data are available for these special patients and, crucially, estimates for infant exposure are lacking. Therefore, the manufacturer recommends against using DOACs during the lactation period. We present the case of a patient who stopped breastfeeding owing to a diagnosis of postpartum cardiomyopathy. Anticoagulation with enoxaparin that commenced after the diagnosis of postpartum pulmonary embolism was switched to rivaroxaban. At that time, breast milk samples were collected and rivaroxaban concentrations were determined by liquid chromatography tandem-mass spectrometry. Rivaroxaban appears in human breast milk in comparatively small amounts; its safety has not been determined.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wiesen, Martin H. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Blaich, Cornelia UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Streichert, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-270897
DOI:	10.1016/j.chest.2016.01.021
Journal or Publication Title:	Chest
Volume:	150
Number:	1
Page Range:	S. E1 - 4
Date:	2016
Publisher:	AMER COLL CHEST PHYSICIANS
Place of Publication:	GLENVIEW
ISSN:	0012-3692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ORAL ANTICOAGULANTS Multiple languages Critical Care Medicine; Respiratory System Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27089