Alteplase and Breastfeeding

Summary of use during lactation

Tissue plasminogen activator (tPA), which is identical to alteplase, is a normal component of human colostrum and breastmilk.[1-3] Levels in milk are highest in colostrum and decrease rapidly during the first week, followed by a slower decrease over time.[2,3] Because alteplase is a large protein molecule with a molecular weight of about 59,000 Da, absorption is unlikely because it is probably partially destroyed in the infant's gastrointestinal tract and poorly absorbed orally. No information is available on the clinical use of alteplase during breastfeeding. Until more data become available, alteplase should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

References

1. Heegaard C, Larsen L, Rasmussen L, et al. Plasminogen activation system in human milk. J Pediatr Gastroenterol Nutr 1997;25:159-66.9252902 PubMed
2. Marshall J, Rees M, Cederholm-Williams S. Identification of t-PA as the major active plasminogen activator in human milk. Thromb Haemost 1986;55:279-81.3087004 PubMed
3. Ishii A, Yamada S, Yamada R, et al. Determination of t-PA activity and t-PA antigen in human milk. J Perinat Med 1992;20:203-7.1453294 PubMed