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

Perindopril

July 31, 2018 (Very Low Risk)

Perindopril and its active metabolite perindoprilat 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, Lwin 2017).

Until there is more information about this drug in relation to breastfeeding, safer known alternatives are preferable.

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.

Synonyms

  • Perindopril Arginine
  • Perindopril Erbumine

Writings

  • Περινδοπρίλη (Greek)
  • بيريندوبريل (Arabic)
  • Периндоприл (Cyrillic)
  • 培哚普利 (Chinese)
  • ペリンドプリル (Japanese)
  • Périndopril (French)
  • C19 H32 N2 O5 (Molecular formula)
  • (2S,3aS,7aS)-1-{N-[(S)-1-Ethoxycarbonylbutyl]-l-alanyl}perhydroindole-2-carboxylic acid (Chemical name)
  • C09AA04 (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. Lwin EMP, Gerber C, Song Y, Leggett C, Ritchie U, Turner S, Garg S. A new LC-MS/MS bioanalytical method for perindopril and perindoprilat in human plasma and milk. Anal Bioanal Chem. 2017Abstract
  4. 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
  5. AEMPS. Perindopril Ficha técnica. 2012 Full text (in our servers)
  6. FDA. Perindopril. Drug Summary. 2011 Full text (in our servers)