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Lepirudin use while Breastfeeding

Medically reviewed by Last updated on Jan 16, 2024.

Drugs containing Lepirudin: Refludan

Lepirudin Levels and Effects while Breastfeeding

Summary of Use during Lactation

Lepirudin is no longer marketed in the United States. Limited information indicates that lepirudin in doses up to 100 mg daily produce very low levels in milk. Because of its large molecular weight, it would not be expected to be absorbed from breastmilk by the infant. Lepirudin would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months.[1]

Drug Levels

Maternal Levels. One mother who was 10 weeks postpartum received lepirudin 50 mg twice daily subcutaneously. Her breastmilk had undetectable (<0.1 mg/L) lepirudin levels 3 hours after a dose.[2]

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

Effects in Breastfed Infants

One infant was breastfed for 3 months during therapeutic lepirudin use beginning at 7 weeks of age. No bleeding events occurred.[2]

Effects on Lactation and Breastmilk

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

Alternate Drugs to Consider

Acenocoumarol, Dalteparin, Enoxaparin, Heparin, Rivaroxaban, Warfarin


Bates SM, Rajasekhar A, Middeldorp S, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: Venous thromboembolism in the context of pregnancy. Blood Adv. 2018;2:3317–59. [PMC free article: PMC6258928] [PubMed: 30482767]
Lindhoff-Last E, Willeke A, Thalhammer C, et al. Hirudin treatment in a breastfeeding woman. Lancet. 2000;355:467–8. [PubMed: 10841132]

Substance Identification

Substance Name


CAS Registry Number


Drug Class

Breast Feeding


Milk, Human



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Further information

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