Last update: April 2, 2015

Telmisartan

High Risk for breastfeeding


Poorly safe. Evaluate carefully.
Use safer alternative or interrupt breastfeeding 3 to 7 T½.
Read the Comment.

At latest update, relevant published data on excretion into breast milk were not found.

Because of a high protein-binding capacity, a significant excretion into breast milk is unlikely.

However, it is one among the Sartan drugs (ARA-II type) with the longest half-life and highest oral bioavailability. The latter properties make it less convenient for use while breastfeeding.

Reportedly, a newborn infant appeared with transient renal failure (kidney malfunction) whose mother had taken Telmisartan during 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.

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Tradenames

Main tradenames from several countries containing Telmisartan in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 40 - 58 %
Molecular weight 515 daltons
Protein Binding 100 %
VD 6,9 l/Kg
Tmax 1 - 3 hours
T1/2 24 hours

References

  1. 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. 2016 Abstract Full text (link to original source) Full text (in our servers)
  2. Boe.Ing. Telmisartan. Drug Summary. 2013 Full text (in our servers)
  3. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  4. AEMPS. Telmisartán. Ficha técnica. 2010 Full text (in our servers)
  5. 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)
  6. 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. 2003 Abstract Full text (link to original source) Full text (in our servers)

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