NADROPARIN

Fetal Risk Summary

Nadroparin is a low-molecular-weight heparin prepared by depolymerization of heparin obtained from porcine intestinal mucosa (1). It is not available in the United States (see also Dalteparin and Enoxaparin).

One report described the prophylactic use of nadroparin throughout pregnancy in seven women, all with a history of deep vein thrombosis of a lower limb, with familial thrombophilia (2). The pregnancies resulted in normal, healthy newborns. No maternal thromboembolic or hemorrhagic complications were observed, and thrombocytopenia did not occur. Osteoporosis was not studied (2).

Nadroparin has an average molecular weight of about 4500 (1). Because this is a relatively large molecule, it probably does not cross the placenta and, thus, presents a low risk to the fetus.

Breast Feeding Summary

No reports describing the use of nadroparin during lactation or breast feeding have been located. Nadroparin, a low-molecular-weight heparin, still has a relatively high molecular weight (average 4500) and, as such, should not be expected to be excreted into human milk. Because nadroparin would be inactivated in the gastrointestinal tract, the risk to a nursing infant from ingesting the drug from milk appears to be negligible.

References

1. Reynold JEF, ed. Martindale. The Extra Pharmacopoeia. 30th ed. London: The Pharmaceutical Press, 1993:231–2.
2. Boda Z, Laszlo P, Rejto L, Tornai I, Pfliegler G, Blasko G, Rak K. Low molecular weight heparin as thromboprophylaxis in familial thrombophilia during the whole of pregnancy. Thromb Haemost 1996;76:128.