Is Edoxaban safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Edoxaban. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Two women had low breastmilk levels after taking edoxaban 60 mg daily for 3 days and twin infants were partially breastfed during their mother’s edoxaban use without any bleeding. However, 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]
Effects on the breastfed infant
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.[4]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. Two women volunteered to take edoxaban 60 mg daily for 3 days and donate milk samples. The average milk concentration over 24 hours was 68.9 mcg/L resulting in an average infant intake of 10.3 mcg/kg daily or a relative infant dose of 1.2%. A physiologically based pharmacokinetic model accurately predicted the milk concentrations.[3]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Edoxaban in pregnancy
LactMed covers breastfeeding only. For what the NHS and the US prescribing label say about pregnancy, see:
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Edoxaban” (LM1167). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.