What recommendations did the MHRA make regarding the use of ACE inhibitors and angiotensin II receptor antagonists during breastfeeding?
In 2009, the MHRA issued a drug safety update on ACE inhibitors and angiotensin II receptor antagonists, recommending that they should not be used by breastfeeding mothers, but that they are not absolutely contraindicated. Healthcare professionals may prescribe these medicines during breastfeeding if they consider that this treatment is essential for the lactating mother. In mothers who are breastfeeding older infants, the use of captopril, enalapril, or quinapril may be considered if an ACE inhibitor is necessary for the mother. Careful follow-up of the infant for possible signs of hypotension is also recommended.