Clopidogrel Levels and Effects while Breastfeeding
Summary of Use during Lactation
Information from two mothers indicates that minute quantities of clopidogrel and its metabolites are excreted into milk and one breastfed infant had trivial serum levels. Two mothers and the manufacturer reported that no adverse effects have been observed in breastfed infants with maternal clopidogrel use during lactation in a small number of cases. It appears that clopidogrel can be used in nursing mothers.
Drug Levels
Maternal Levels. Milk samples were obtained over a 24-hour period from two nursing mothers who were taking clopidogrel 75 mg daily. The milk was analyzed for clopidogrel, its active metabolite (CAMD) and clopidogrel carboxylic acid. Using standard milk intake, the infant dosages were 144 mg/kg of clopidogrel, 3 ng/kg of the CAMD active metabolite and 1110 ng/kg for clopidogrel carboxylic acid daily. These values translated to a relative infant dose of 0.008%.[1]
Infant Levels. An infant aged 14 months was partially breastfed by a mother taking clopidogrel 75 mg daily. A blood sample was obtained from the infant. The concentrations in the infant blood sample were clopidogrel <0.01 mcg/L, CAMD <0.01 mcg/L, and clopidogrel carboxylic acid 0.05 mcg/L.[1]
Effects in Breastfed Infants
Two infants aged 7 to 14 months were partially breastfed by mothers taking clopidogrel 75 mg daily. No adverse health issues were reported for either infant by their mothers.[1]
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Van Neste M, Nauwelaerts N, Mols R, et al. Case series: Clopidogrel exposure in human milk: The UmbrelLACT study - a contribution from the ConcePTION project. Neurotoxicol Teratol 2024;104:107359. doi:10.1016/j.ntt.2024.107359 [CrossRef]
Substance Identification
Substance Name
Clopidogrel
CAS Registry Number
120202-66-6
Drug Class
Lactation
Breast Feeding
Milk, Human
Platelet Aggregation Inhibitors
Purinergic P2Y Receptor Antagonists
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