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Warning on use of ARBs in breast-feeding

By Nigel Praities

Angiotensin-receptor blockers and certain ACE-inhibitors should not be used by breastfeeding mothers, says the drugs regulator.

The Medicines and Healthcare products Regulatory Agency said there was not enough evidence to rule out a risk of profound neonatal hypotension when breast-feeding mothers were taking the drugs – especially in pre-term babies.

Certain ACE-inhibitors – captopril, enalapril, or quinapril – can be used during breast-feeding, but only after a few weeks following delivery says the agency in its Drug Safety Update for this month.

‘Use may be considered when the infant is older if an ACE inhibitor is necessary for the mother; careful follow-up of the infant for possible signs of hypotension is recommended,' the advice reads.

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