Is Valsartan (Angiotensin II Receptor Antagonist) safe during pregnancy?

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Last updated: May 31, 2025View editorial policy

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From the Guidelines

Valsartan is not safe for use during pregnancy due to the potential risk of serious harm to the developing fetus. According to the most recent and highest quality study, 1, treatment with angiotensin receptor blockers (ARBs) like valsartan is contraindicated during pregnancy because they may cause fetal renal dysplasia, oligohydramnios, pulmonary hypoplasia, and intrauterine growth restriction.

The potential risks associated with valsartan use during pregnancy include:

  • Decreased fetal kidney function
  • Oligohydramnios (low amniotic fluid)
  • Skull and lung development problems
  • Fetal death

If you are pregnant or planning to become pregnant while taking valsartan for conditions like hypertension or heart failure, you should contact your healthcare provider immediately to discuss switching to pregnancy-safe alternatives. Some safer options for managing high blood pressure during pregnancy include:

  • Methyldopa
  • Labetalol
  • Certain calcium channel blockers

Women of childbearing age who are prescribed valsartan should use reliable contraception and inform their doctor right away if pregnancy occurs or is suspected, as the medication should be discontinued as soon as possible, as stated in 1 and 1.

From the FDA Drug Label

Valsartan tablets can cause fetal harm when administered to a pregnant woman. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death When pregnancy is detected, consider alternative drug treatment and discontinue valsartan tablets as soon as possible.

Valsartan is not safe for pregnancy. It can cause fetal harm, reduce fetal renal function, and increase fetal and neonatal morbidity and death. If pregnancy is detected, alternative drug treatment should be considered and valsartan should be discontinued as soon as possible 2.

From the Research

Valsartan Safety in Pregnancy

  • The safety of Valsartan during pregnancy is a concern due to its potential effects on the fetus 3, 4.
  • Studies have shown that angiotensin II receptor antagonists, including Valsartan, can cause fetal toxicity, particularly in the second and third trimesters 3.
  • Adverse effects associated with Valsartan use during pregnancy include oligohydramnios, fetal growth retardation, pulmonary hypoplasia, limb contractures, and calvarial hypoplasia 3.
  • However, one case report suggests that the adverse fetal effects of Valsartan may be reversible if the treatment is stopped early in pregnancy 4.
  • It is recommended that maternal treatment with AT1 receptor antagonists, including Valsartan, be avoided during the second and third trimesters of pregnancy 3.

Alternative Antihypertensive Medications

  • Other antihypertensive medications, such as methyldopa, labetalol, and nifedipine, have been found to be safe and effective for use during pregnancy 5, 6, 7.
  • These medications have been shown to reduce blood pressure and minimize the risk of adverse maternal and fetal outcomes 5, 7.
  • However, more research is needed to fully understand the pharmacokinetics and pharmacodynamics of these medications during pregnancy 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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