Ramipril
Ramipril and its active metabolite Ramiprilat are angiotensin converting enzyme inhibitors (ACEI) used in the treatment of hypertension, nephropathy, heart failure and to reduce the risk of cardiovascular damage.
Oral administration every 12 - 24 hours.
According to the manufacturer (FDA 2013, AEMPS 2009) no levels were detected in breast milk after a dose of ramipril, but since the last update we have not found other 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 (Anderson 2018, Hale 2017 p830, Malachias 2016).
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).
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
- ραμιπρίλη (Greek)
- راميبريل (Arabic)
- Рамиприл (Cyrillic)
- 雷米普利 (Chinese)
- ラミプリル (Japanese)
- C23 H32 N2 O5 (Molecular formula)
- (2S,3aS,6aS)-1-{N-[(S)-1-Ethoxycarbonyl-3-phenylpropyl]l-alanyl}perhydrocyclopenta[b]pyrrole-2-carboxylic acid (Chemical name)
- C09AA05 (ATC Code/s)
Drug trade names
- Acovil™
- Altace™
- Ampril (Амприл)™
- Amprilan (Амприлан)™
- Atensec™
- Brefit™
- Carasel™
- Delix™
- Ecator™
- Hartil (Хартил)™
- Hypren™
- Intemipril™
- Lannapril™
- Lastace™
- Lostapres™
- Naprix™
- Piramil (Пирамил)™
- Piramil™
- Polapril (Полаприл)™
- Prilace™
- Prilamil™
- Prilver™
- Ramace™
- Rami (Рами)™
- Ramiclair™
- Ramigamma™
- RamiLich™
- Ramipres™
- Ramipro™
- Ramitren (Рамитрен)™
- Ramizes (Рамизес)™
- Romace™
- Stibenyl™
- Triacor™
- Triapin™
- Triatec™
- Tritace (Тритаце)™
- Tritace™
- Tryzan™
- Unimax™
- Venesden™
- Verzatec™
- АМПРИЛ®
- АНГІРАМ
- БРЮМІПРИЛ
- КАРДИПРИЛ 10
- КАРДИПРИЛ 2,5
- КАРДИПРИЛ 5
- ПОЛАПРИЛ
- РАМАГ
- РАМІ САНДОЗ®
- РАМІЗЕС
- РАМІМЕД
- РАМІПРИЛ
- РАМІПРИЛ АЙКОР®
- РАМІПРИЛ-ТЕВА
- РАМКОР - 2,5
- РАМКОР - 5
- РАМКОР-10
- ТОПРИЛ
- ТРИТАЦЕ®
- ХАРТИЛ®
References
- Park S, Choi NK. Breastfeeding and Maternal Hypertension. Am J Hypertens. 2018Abstract
- Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018Abstract
- Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
- 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)
- AEMPS. Ramipril. Ficha técnica. 2016 Full text (in our servers)
- 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
- FDA (Pfizer). Ramipril. Drug Summary. 2013 Full text (in our servers)
- van Griensven JM, Schoemaker RC, Cohen AF, Luus HG, Seibert-Grafe M, Röthig HJ. Pharmacokinetics, pharmacodynamics and bioavailability of the ACE inhibitor ramipril. Eur J Clin Pharmacol. 1995Abstract
- Meisel S, Shamiss A, Rosenthal T. Clinical pharmacokinetics of ramipril. Clin Pharmacokinet. 1994Abstract