TABLE 3.

Safety of anti-thrombotic drugs during pregnancy and breastfeeding.

Drugs	Risk category	Placenta permeable	Transfer to breast milk	Safety data
Antiplatelet drugs
Abciximab	C	Unknown	Unknown	Inadequate human studies
Acetylsalicylic acid (low dose)	B	Yes	Yes (no adverse effects reported)	No teratogenic effects (inadequate human studies regarding the use of doses between 100–500 mg/day)
Cangrelor	C	Unknown	Unknown	No human data
Clopidogrel	B	Unknown	Yes	No adequate human data
Prasugrel	–	Unknown	Yes	Inadequate human data
Ticagrelor	–	Unknown	Yes	Inadequate human data; not recommended
Ticlopidine	C	Unknown	Yes	Inadequate human data
Vorapaxar	–	Unknown	Yes	Inadequate human data
Anticoagulants
Acenocoumarol	D	Yes	Yes (no adverse effects reported)	Embryopathy (mainly first trimester),
Apixaban	–	Yes	Yes	No human data: not recommended
Dabigatran	–	Yes	Unknown	No human data; not recommended
Edoxaban	–	Unknown	Yes (contraindicated in breastfeeding)	Contraindicated; Hokusai-VTE study: 10 cases with exposure in first trimester, for up to 6 weeks. Results: six live births (four full term and two pre-term), one first trimester spontaneous abortion, and three elective terminations
Fondaparinux	–	Yes	Yes	Inadequate human data
Heparin (low molecular weight)	B	No	No	Retrospective cohort study with 693 live births: no increased risk of major developmental abnormalities
Heparin (unfractionated)	B	No	No	Human data: no fetus abnormalities
Phenprocoumon	D	Yes	Yes	Coumarin embryopathy
Rivaroxaban	–	Yes	Yes	Inadequate human data (contraindicated)
Warfarin	D	Yes	Yes	Coumarin embryopathy