Phenprocoumon and Breastfeeding

Summary of use during lactation

Phenprocoumon is not approved by the U.S. Food and Drug Administration (FDA). Limited information indicates that anticoagulant maternal doses of phenprocoumon produce low levels in milk. Until more data are available, shorter-acting anticoagulants are preferred, especially if the infant is younger than 2 months.

Drug levels in milk and infant serum

Maternal Levels. One mother required anticoagulation postpartum was given phenprocoumon as an anticoagulant. Milk samples were obtained on days 27, 28 and 31 postpartum when her prothrombin time and phenprocoumon serum concentrations were stable. Milk phenprocoumon concentrations varied between 26 and 76 mcg/L and concentrations were higher in hindmilk than foremilk. A complete 24-hour milk collection contained a concentration of 33 mcg/L of phenprocoumon.[1] 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.

Alternative drugs to consider

Acenocoumarol, Dalteparin, Enoxaparin, Heparin, Rivaroxaban, Warfarin

References

1. von Kries R, Nocker D, Schmitz-Kummer E, et al. Transfer of phenprocoumon in breast milk. Is oral anticoagulation with phenprocoumon a contraindication for breastfeeding? Monatsschr Kinderheilkd 1993;141:505-7.8336747 PubMed