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Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.

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Drugs and Lactation Database (LactMed) [Internet].

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Last Revision: November 16, 2020.

Estimated reading time: 1 minute

CASRN: 503612-47-3

image 135252374 in the ncbi pubchem database

Drug Levels and Effects

Summary of Use during Lactation

Preliminary information from one mother indicates that apixaban levels in milk are rather high. An alternate drug is preferred, especially while nursing a newborn or preterm infant.[1-3]

Drug Levels

Maternal Levels. A nursing mother who was 23 months postpartum received 2 doses of 5 mg of oral apixaban 12 hours apart. Blood and milk samples were obtained before the first dose and at 3.5, 7, 12 (before the second dose), 16, and 24 hours after the first dose. Peak apixaban milk levels of about 230 mcg/L occurred at 3.5 to 4 hours after each dose. The average milk level over 24 hours was 113.6 mcg/L, which corresponds to a daily infant dosage of 17 mcg/kg daily and a relative infant dose of 12.8% of the maternal weight-adjusted dosage.[3]

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

Effects in Breastfed Infants

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

Effects on Lactation and Breastmilk

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


Vanassche T, Vandenbriele C, Peerlinck K, et al. Pharmacotherapy with oral Xa inhibitors for venous thromboembolism. Expert Opin Pharmacother. 2015;16:645–58. [PubMed: 25554350]
Cohen H, Arachchillage DR, Beyer-Westendorf J, et al. Direct oral anticoagulants and women. Semin Thromb Hemost. 2016;42:789–97. [PubMed: 27706531]
Zhao Y, Arya R, Couchman L, et al. Are apixaban and rivaroxaban distributed into human breast milk to clinically relevant concentrations? Blood. 2020;136:1783–5. [PubMed: 32488251]

Substance Identification

Substance Name


CAS Registry Number


Drug Class

Breast Feeding




Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.


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