From the Guidelines
Enalapril is recommended at a maximum dose of 40 mg/d, or 20 mg BID, for lactating women, as it is considered safe with a relative infant dose (RID) of 1.1%. The safety of Enalapril during lactation is supported by its low RID, which indicates that only a small amount of the drug is passed into breast milk 1. Key considerations for the use of Enalapril in lactating women include:
- Monitoring blood pressure regularly to ensure the medication is effectively controlling hypertension
- Using the lowest effective dose for the shortest necessary duration
- Being aware of potential side effects in breastfed infants, such as poor feeding, excessive sleepiness, or inadequate weight gain, although these are rarely reported
- Considering the potential increased sensitivity of premature infants or newborns with immature kidney function to ACE inhibitors. It is essential to weigh the benefits of Enalapril in managing hypertension against the potential risks to the breastfed infant, and the recommended dose of 40 mg/d, or 20 mg BID, is considered safe and effective for lactating women 1.
From the Research
Enalapril Dose in Lactation
- The recommended dose of Enalapril for a lactating woman is not explicitly stated in the provided studies.
- However, study 2 discusses the safety of various drugs during lactation, including analgesics, but does not provide information on Enalapril.
- Study 3 reviews the use of antibiotics and analgesics during lactation, but also does not mention Enalapril.
- Study 4 provides information on the human pharmacology of Enalapril, including its metabolism and excretion, but does not address its use during lactation.
- Studies 5 and 6 discuss the use of Enalapril in infants, including its safety and dosing, but do not provide guidance on its use in lactating women.
Safety Considerations
- When considering the use of Enalapril in a lactating woman, it is essential to weigh the potential benefits against the potential risks to the infant.
- As Enalapril is excreted in breast milk, the infant may be exposed to the drug, and the potential effects on the infant should be considered.
- However, without specific studies on the use of Enalapril during lactation, it is challenging to provide a recommended dose or guidance on its safety.