From the Guidelines
ACE inhibitors are not contraindicated in lactation, but ARBs are generally not recommended due to insufficient safety data. The most recent and highest quality study 1 suggests that ACE inhibitors, such as enalapril or captopril, can be used in lactating mothers, with monitoring of neonatal weight. However, the same study does not provide sufficient evidence for the safety of ARBs during lactation. Other alternatives with well-established safety profiles, such as labetalol, nifedipine, and methyldopa, can be considered for blood pressure control during breastfeeding. It is essential to note that the decision to use any medication during lactation should be made after consulting with a healthcare provider and considering the individual circumstances of the mother and infant. Previous studies 1 and 1 also support the use of ACE inhibitors during lactation, but emphasize the importance of monitoring infant weight and renal function. In contrast, the lack of research on ARBs during lactation means that their safety profile cannot be confidently established, and therefore, they are generally not recommended. Overall, the available evidence suggests that ACE inhibitors can be a safe option for lactating mothers who require antihypertensive medication, but ARBs should be avoided due to insufficient safety data. Key points to consider when prescribing antihypertensive medication during lactation include:
- The safety profile of the medication
- The potential risks and benefits to the mother and infant
- The need for monitoring of infant weight and renal function
- The availability of alternative medications with well-established safety profiles.
From the Research
ACE Inhibitors and ARBs in Lactation
- There is no direct evidence in the provided studies regarding the contraindication of ACE inhibitors and ARBs in lactation.
- The studies primarily focus on the comparison of ACE inhibitors and ARBs in the treatment of hypertension, their efficacy, and safety in various patient populations 2, 3, 4, 5.
- One study discusses the use of ACE inhibitors and ARBs in the chronotherapeutic treatment of hypertension, but does not address lactation 6.
- Therefore, there are no research papers in the provided evidence to assist in answering the question about the contraindication of ACE inhibitors and ARBs in lactation.