Announcement

Collapse
No announcement yet.

Welcome to our forum! Before posting your questions, please read the following terms:

  1. 1. Forum questions will be responded to by InfantRisk staff as schedules permit during normal business hours.
  2. 2. This forum is not intended for emergencies or urgent care. For any immediate medical concerns, please seek appropriate medical attention.
  3. 3. Any statements made by team members should be discussed with your medical care team. Your healthcare providers know you (and your baby) best, and should have a better understanding of your unique situation.
  4. 4. We are a small team dedicated to helping you as best as we can. However, for the quickest response, we recommend calling the InfantRisk Center at +1(806) 352-2519.

By posting to the forums, you acknowledge and agree to these terms.

The InfantRisk team

Enalapril

Collapse
X
Collapse
 
  • Page of 1
  • Filter
  • Time
  • Show
Clear All
new posts
Previous template Next
  • #1

    Enalapril

    I'm nursing an 11 week old infant, and am currently taking labetalol and cardizem. My nephrologist wants to put me back on Enalapril for FSGS.

    I'm finding conflicting information on the internet about the safety of Enalapril for a nursing infant. Some information says that it is excreted in small amounts and isn't known to cause problems. But both my nephrologist and our pediatrician say that it isn't approved for lactation.

    I very much want to keep nursing, and am weighing my options. Any advice would be very much appreciated.

    Thank you in advance,
    Allison Hamilton
    Tags: None
  • #2
    allison:

    First, NO drug is approved from breastfeeding mothers, and we all know that this is simply crazy. Most all drugs are safe to use.

    Below is what we do know.


    Tom Hale Ph.D.

    ---------------------

    Enalapril maleate is an ACE inhibitor used as an antihypertensive. Upon absorption, it is rapidly metabolized by the adult liver to enalaprilat, the biologically active metabolite. In one study of 5 lactating mothers who received a single 20 mg dose, the mean maximum milk concentration of enalapril and enalaprilat was only 1.74 µg/L and 1.72 µg/L respectively.[1] The author suggests that an infant consuming 850 mL of milk daily would ingest less than 2 µg of enalapril daily. The milk/plasma ratios for enalapril and enalaprilat averaged 0.013 and 0.025 respectively. However, this was only a single dose study, and the levels transferred into milk at steady state may be slightly higher.

    In a study by Rush of a patient receiving 10 mg/day, the total amount of enalapril and enalaprilat measured in milk during the 24 hour period was 81.9 ng and 36.1 ng respectively or 1.44 µg/L and 0.63 µg/L of milk respectively.[2] Some caution is recommended in using ACE inhibitors in mothers with premature infants due to possible renal toxicity.

    1.Redman CW, Kelly JG, Cooper WD. The excretion of enalapril and enalaprilat in human breast milk. Eur J Clin Pharmacol 1990; 38(1):99.
    2.Rush JE, Snyder BA, Barrish A. et.al. Comment. Clin Nephrol 1991; 35:234.

    Comment

    Previous template Next
    Working...
    X