At latest update, relevant published data on excretion into breast milk were not found.
A high protein-binding capacity makes excretion into breast milk unlikely. In addition, a low oral bioavailability makes difficult the absorption towards the infant's plasma from ingested milk, except in prematures or newborns who may show an increased absorption.
Case report of kidney function impairment of a baby whose mother had taken Telmisartan in pregnancy.
Until more data on this medication is available, safer alternative drugs are preferred, especially in premature babies or during the neonatal period.
Should an ARA-II medication (Sartan type) be necessary, the associated risk may be decreased by choosing the one with a favorable pharmacokinetics (shorter half-life elimination time and lower bioavailability) like Eprosartan and Losartan
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
Drug trade names
- 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)
- Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
- AEMPS. Valsartán. Ficha técnica. 2009 Full text (in our servers)
- MHRA. Valsartan. Drug Summary. 2009 Full text (in our servers)
- Tamargo j, Caballero R, Gómez R, Núñez L, Vaquero M y Delpón E. Características farmacológicas de los ARA-II. ¿Son todos iguales?. Rev Esp Cardiol Supl. 2006;6:10C-24C. 2006 Full text (in our servers)
- Pietrement C, Malot L, Santerne B, Roussel B, Motte J, Morville P. Neonatal acute renal failure secondary to maternal exposure to telmisartan, angiotensin II receptor antagonist. J Perinatol. 2003Abstract Full text (link to original source) Full text (in our servers)