is no information on the amount of prasugrel which passes into breast milk although levels are likely to be low. It can be used with caution during breastfeeding but monitoring is required
monitoring
monitor the infant for skin reactions, and for signs of bruising or bleeding which could be prolonged
Notes:
is no published evidence of use of ticagrelor during breastfeeding
LactMed states (2)
because ticagrelor and its active metabolite are more than 99% bound to plasma proteins, the amount in milk is likely to be low
if ticagrelor is used by a nursing mother, monitor the infant for bruising and bleeding
an alternate drug may be preferred, especially while nursing a newborn or preterm infant
ticagrelor's high protein binding is likely to limit the amount excreted into milk. However, prasugrel irreversibly binds to platelets so any that is absorbed could have a prolonged effect
no side effects have been reported in breastfed infants
as ticagrelor has a reversible antiplatelet effect, the duration of any potential side effects relating to bleeding would be less than with an irreversible antiplatelet agent (1)
Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Ticagrelor. [Updated 2019 Jun 3]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK543167/
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