Irbesartan use with occasional breastfeeding

[Jess]

Hello,
My doctor recently recommended switching from labetalol to Irbesartan because my hypertension is no longer well controlled with Labetalol. The information leaflet from pharmacy indicated that breastfeeding is not recommended while on Irbesartan. My 17 month old has pretty much weaned herself at this point, but will ask for the odd nursing session (every couple of days, and mostly comfort nursing). Is this contraindicated? I haven't started the new medication yet, and could hold off a bit longer until my little one is fully weaned (but my pressures would not be well controlled in the meantime). Any help in sorting this out would be greatly appreciated!
Jessica

[Sandra]

Jess, thanks for your post,

Irbesartan is given a rating of L3- probably compatible, we have have no data on how much transfers into human milk, but low concentrations are passed in rodent milk. In your particular situation where your little girl is older and is not breastfeeding very often it would probably be ok to continue breastfeeding as long as she is not symptomatic. Monitor her for drowsiness, lethargy, pallor, poor feeding and weight gain. We have more data on captopril and enalapril both which are given a rating of L2- safest.

Both the ACE inhibitor family and the specific Angiotensin II receptor blockers are contraindicated in pregnancy and thus should be used with caution in women who are planning a subsequent pregnancy in the near future.

I hope this helps, if you have any other questions please call the InfantRisk Center at 806-352-2519, thanks.

Sandra Lovato R.N.
InfantRisk Center