Dalteparin use while Breastfeeding
Drugs containing Dalteparin: Fragmin
Dalteparin Levels and Effects while Breastfeeding
Summary of Use during Lactation
Because of the low levels of dalteparin in breastmilk and its large molecular weight of 2000 to 9000 daltons, amounts ingested by the infant are small and it would not be expected to be absorbed from breastmilk by the infant. No special precautions are required.
Maternal Levels. In two women receiving subcutaneous dalteparin 5000 IU/day and 10,000 IU/day, respectively, dalteparin was undetectable in breastmilk.
Anti-Xa activity (a measurement of anticoagulant activity) was measured in the milk of 15 patients before and 3 to 4 hours after 4 to 8 days at a dosage of 2500 IU/day subcutaneously. Anti-Xa activity in milk ranged from less than 5 to 37 IU/L which was 2.5 to 22.4% of the simultaneous maternal plasma anti-Xa activity.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Although not clearly stated, it appears that 15 neonates were breastfed during maternal dalteparin use in one study with no adverse effects reported.
In another report, one mother breastfed her infant for 20 days starting at 7 weeks of age while taking subcutaneous dalteparin 5000 IU subcutaneously twice daily with no adverse effects to her infant.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
1. Bates SM, Greer IA, Middeldorp S et al. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141 (2 Suppl):e691S-736S. PMID: 22315276
2. Harenberg J, Leber G, Zimmermann R et al. [Prevention of thromboembolism with low-molecular weight heparin in pregnancy]. Geburtshilfe Frauenheilkd. 1987;47:15-8. PMID: 3569823
3. Richter C, Sitzmann J, Lang P et al. Excretion of low molecular weight heparin in human milk. Br J Clin Pharmacol. 2001;52:708-10. PMID: 11736885
4. Lindhoff-Last E, Willeke A, Thalhammer C et al. Hirudin treatment in a breastfeeding woman. Lancet. 2000;355:467-8. PMID: 10841132
Low Molecular Weight Heparin
LactMed Record Number
Last Revision Date
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