Is Benazepril Hydrochloride compatible with breastfeeding? Do we have alternatives for Benazepril Hydrochloride?

Benazepril Hydrochloride

July 31, 2018 (Very Low Risk)

Benazepril and its active metabolite benazeprilat are angiotensin converting enzyme inhibitors (ACEI) used in the treatment of hypertension and heart failure. Oral administration every 12-24 hours.

It is excreted in breastmilk in clinically insignificant amounts (Anderson 2018, AEMPS 2017, FDA 2015, Frank 2004, Shannon 2000, Kaiser 1989) and no problems have been observed in infants whose mothers were taking it (Anderson 2018).

Due to its possible renal toxicity in preterm infants, it is preferable to avoid its use during the neonatal period in case of prematurity. (Serrano 2015).

The protective role of breastfeeding against maternal hypertension has been proven (Park 2018)

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Writings

  • Βεναζεπρίλη (Greek)
  • Беназеприла Гидрохлорид (Cyrillic)
  • ベナゼプリル塩酸塩 (Japanese)
  • Bénazépril, Chlorhydrate de (French)
  • C24 H28 N2 O5, HCl (Molecular formula)
  • {(3S)-3-[(1S)-1-Ethoxycarbonyl-3-phenylpropylamino]-2,3,4,5-tetrahydro-2-oxo-1H-1-benzazepin-1-yl}acetic acid hydrochloride; 1-Carboxymethyl-3-[1-ethoxycarbonyl-3-phenyl-(1S)-propylamino]-2,3,4,5-tetrahydro-1H-1(3S)-benzazepin-2-one hydrochloride (Chemical name)

Drug trade names

References

  1. Park S, Choi NK. Breastfeeding and Maternal Hypertension. Am J Hypertens. 2018Abstract
  2. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018Abstract
  3. AEMPS. Benazepril. Ficha técnica. 2017 Full text (in our servers)
  4. Malachias MV, Figueiredo CE, Sass N, Antonello IC, Torloni MR, Bortolotto MRF L. 7th Brazilian Guideline of Arterial Hypertension: Chapter 9 - Arterial Hypertension in pregnancy Arq Bras Cardiol. 2016Abstract Full text (link to original source) Full text (in our servers)
  5. FDA -Validus Pharm. Benazepril. Drug Summary. 2015 Full text (in our servers)
  6. Serrano Aguayo P, García de Quirós Muñoz JM, Bretón Lesmes I, Cózar León MV. Tratamiento de enfermedades endocrinológicas durante la lactancia. [Endocrinologic diseases management during breastfeeding.] Med Clin (Barc). 2015Abstract
  7. Frank J Nice, Deborah DeEugenio, Traci A DiMino, Ingrid C Freeny, Marissa B Rovnack, and Joseph S Gromelski. Medications and Breast-Feeding: A Guide for Pharmacists, Pharmacy Technicians, and other Healthcare Professionals Part II. Journal of Pharmacy Technology 20 (2), 85-95 2004 Full text (link to original source) Full text (in our servers)
  8. Shannon ME, Malecha SE, Cha AJ. Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) and lactation: an update. J Hum Lact. 2000Abstract
  9. Kaiser G, Ackerman R, Dieterle W, Fleiss PM. Benazepril and benazeprilat in human plasma and breast milk (abstract). Eur J Clin Pharmacol 1989;36(Suppl): page 303, poster 14.14. 1989