Ticagrelor (Brilinta) and breastfeeding

[Bianca Balassiano]

Is it safe to breastfeed taking Ticagrelor (Brilinta)? I couldn't find any research in traditional ways and I could use some help. Thank you, Bianca

[admin]

Bianca:

Ticagrelor is an anticoagulant similar to clopidogrel and prasugrel. Unlike these other agents, ticagrelor exerts a reversible effect and is not a direct ADP antagonist, but rather prevents ADP from binding to the platelet through allosteric action. There are currently no studies of this drug in breastfeeding women, though it is known to be excreted in the milk of lactating rats. In animal studies, ticagrelor was found to be in greater concentrations in milk than in the maternal plasma. The majority of the radiation was from unchanged drug, while small amounts were from several different metabolites, of which one, AR-C124910XX, is pharmacologically active. Ticagrelor and its active metabolites are highly protein-bound and do not exhibit extensive oral bioavailability.

We simply can't tell you IF it is safe to use during breastfeeding. If you decide to use it, monitor the infant for blood in stool, or unusual bruising. You might have pediatrician run clotting tests. We recently studied another anticoagulant called Rivaroxaban and its levels in milk were exceedingly low. Just FYI.

Tom Hale Ph.D.

[Bianca Balassiano]

Thank you so much Dr. Hale. I'm an admirer of your work and grateful for your contributions. IBCLC in Rio de Janeiro, Brazil.