Last update April 16, 2024

Captopril

Compatible

Safe substance and/or breastfeeding is the best option.

Captopril is an angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension, heart failure, myocardial infarction and type 1 diabetic nephropathy. Oral administration every 8-12-24 hours.

It is excreted in breastmilk in clinically insignificant amounts (Anderson 2018, FT 2018, Serrano 2015, Drummer 1986, Devlin 1981) and no problems have been observed in infants whose mothers were taking it. (Duke 2019, Anderson 2018, Devlin 1981)

Due to its possible renal toxicity in preterm infants, it is preferable to avoid its use during the neonatal period in mothers of premature infants. (Serrano 2015)

There are conflicting reports about the effect of captopril on the secretion of prolactin (Saito 1990, Denolle 1990, Anderson 1989). However, when breastfeeding is well established, milk production does not depend on prolactin levels.

Expert authors and medical associations such as the American Academy of Pediatrics consider it to be usually compatible with breastfeeding (Hale, LactMed, Briggs 2015, Schaefer 2015, Serrano 2015, Rowe 2013, Dennis 2012, Ghanem 2008, AAP 2001, Kirsten 1998). List of essential medicines WHO: compatible with breastfeeding. (WHO/UNICEF, 2002)

Alternatives

We do not have alternatives for Captopril since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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

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Other names

Captopril in other languages or writings:

Groups

Captopril belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Captopril in its composition:

List of 63 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 60 - 75 %
Molecular weight 217 daltons
Protein Binding 25 - 30 %
VD 0.7 l/Kg
pKa 3.7 - 4.02 -
Tmax 1 - 1.5 hours
T½ 2 hours
M/P ratio 0.006 - 0.01 -
Theoretical Dose 0.0007 mg/Kg/d
Relative Dose 0.03 %
Ped.Relat.Dose 0.03 %

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. Duke ME, Britten FL, Pretorius CJ, McWhinney BC, Ungerer JPJ, Barrett HL, Donovan P. Maternal Metyrapone Use During Breastfeeding: Safe for the Breastfed Infant. J Endocr Soc. 2019 Mar 18;3(5):973-978. Abstract
  4. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018 Abstract
  5. AEMPS. Captopril. Ficha técnica. 2017 Full text (in our servers)
  6. 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)
  7. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  8. Serrano Aguayo P, García de Quirós Muñoz JM, Bretón Lesmes I, Cózar León MV. Tratamiento de enfermedades endocrinológicas durante la lactancia. [Endocrinologic diseases management during breastfeeding.] Med Clin (Barc). 2015 Jan 20;144(2):73-9. Abstract
  9. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  10. FDA. Captopril. Drug Summary. 2014 Full text (in our servers)
  11. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  12. Dennis AT. Management of pre-eclampsia: issues for anaesthetists. Anaesthesia. 2012 Sep;67(9):1009-20. Abstract Full text (link to original source) Full text (in our servers)
  13. Ghanem FA, Movahed A. Use of antihypertensive drugs during pregnancy and lactation. Cardiovasc Ther. 2008 Abstract Full text (link to original source) Full text (in our servers)
  14. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  15. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  16. Kirsten R, Nelson K, Kirsten D, Heintz B. Clinical pharmacokinetics of vasodilators. Part II. Clin Pharmacokinet. 1998 Abstract
  17. Denolle T, Rohmer V, Saint-Adnré JP, Guyene TT, Galland F, Bigorgne JC, Schambelan M, Corvol P. Effect of the circulating renin-angiotensin system on prolactin release in humans. J Clin Endocrinol Metab. 1990 Abstract
  18. Saito I, Takeshita E, Hayashi S, Takenaka T, Murakami M, Saruta T, Nagano S, Sekihara T. Effect of captopril on plasma prolactin in patients with essential hypertension. Angiology. 1990 Abstract
  19. Anderson PW, Malarkey WB, Salk J, Kletsky OA, Hsueh WA. The effect of angiotensin-converting enzyme inhibition on prolactin responses in normal and hyperprolactinemic subjects. J Clin Endocrinol Metab. 1989 Abstract
  20. Duchin KL, McKinstry DN, Cohen AI, Migdalof BH. Pharmacokinetics of captopril in healthy subjects and in patients with cardiovascular diseases. Clin Pharmacokinet. 1988 Abstract
  21. Drummer OH, Jarrott B. The disposition and metabolism of captopril. Med Res Rev. 1986 Abstract
  22. Devlin RG, Fleiss PM. Captopril in human blood and breast milk. J Clin Pharmacol. 1981 Abstract

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