Is Lisinopril compatible with breastfeeding? Do we have alternatives for Lisinopril?

Lisinopril

July 31, 2018 (Low Risk)

Lisinopril is an angiotensin-converting enzyme inhibitor (ACEI) used in the treatment of hypertension, heart failure and diabetic nephropathy and as prophylaxis after myocardial infarction.
Oral administration once a day.

Since the last update we have not found published data on its excretion in breastmilk.

Other compounds from the same group (ACEI) are not excreted in breastmilk in significant amounts, but until there is more information about this drug in relation to breastfeeding, safer known alternatives are preferable, especially during the neonatal period and in case of prematurity. (Anderson 2018, Hale 2017 p567, Malachias 2016, AEMPS 2017).

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

  • Λισινοπρίλη (Greek)
  • ليزينوبريل (Arabic)
  • Лизиноприл (Cyrillic)
  • 赖诺普利 (Chinese)
  • リシノプリル (Japanese)
  • C21 H31 N3 O5, 2H2 O (Molecular formula)
  • N-{N-[(S)-1-Carboxy-3-phenylpropyl]-L-lysyl}-L-proline dihydrate (Chemical name)
  • C09AA03 (ATC Code/s)

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. Lisinopril. 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. Astra-Zeneca. Lisinopril. Drug Summary. 2012 Full text (in our servers)