Edoxaban and Breastfeeding

Summary of use during lactation

Two infants were partially breastfed during maternal edoxaban use without bleeding. But because so little information is available on the use of edoxaban during breastfeeding and the drug is orally absorbable, an alternate drug is preferred, especially while nursing a newborn or preterm infant.[1,2]

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

A woman with peripartum cardiomyopathy and severe nonsustained ventricular tachycardia gave birth to twins. Edoxaban 30 mg daily as well as amiodarone, bisoprolol, vonoprazan, febuxostat, imidapril, and pitavastatin were started postpartum. Breastfeeding began 39 days after birth when the daily intake of breastmilk was 160 mL for the first infant and 120 mL for the second, smaller infant. Breastmilk was mixed with infant formula and accounted for approximately one-quarter of their total daily milk intake. The mother breastfed in infants for approximately two months after starting breastfeeding and the infants had no bleeding tendency. At 3 years of age, both infants had a tendency toward obesity, but no other complications or developmental delay.[3]

Effects on lactation and breastmilk

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

Alternative drugs to consider

Acenocoumarol, Dalteparin, Enoxaparin, Heparin, Rivaroxaban, Warfarin

References

1. Vanassche T, Vandenbriele C, Peerlinck K, et al. Pharmacotherapy with oral Xa inhibitors for venous thromboembolism. Expert Opin Pharmacother 2015;16:645–58.25554350 PubMed
2. Cohen H, Arachchillage DR, Beyer-Westendorf J, et al. Direct oral anticoagulants and women. Semin Thromb Hemost 2016;42:789–97.27706531 PubMed
3. Watanabe C, Wachi T, Kamada S, et al. Measurement of amiodarone levels in the breast milk of a Japanese woman with peripartum cardiomyopathy. Cureus 2025;17:e89301.40909045 PubMed