Pregnancy of Kapuseal in details
Kapuseal crosses the placenta (Hurault de Ligny 1987).
Exposure to an angiotensin-converting enzyme (ACE) inhibitor during the first trimester of pregnancy may be associated with an increased risk of fetal malformations (ACOG 203 2019; ESC [Regitz-Zagrosek 2018]); however, outcomes observed may also be influenced by maternal disease (ACC/AHA [Whelton 2018]).
[US Boxed Warning]: Drugs that act on the renin-angiotensin system can cause injury and death to the developing fetus. Discontinue as soon as possible once pregnancy is detected. Drugs that act on the renin-angiotensin system are associated with oligohydramnios. Oligohydramnios, due to decreased fetal renal function, may lead to fetal lung hypoplasia and skeletal malformations. Their use in pregnancy is also associated with anuria, hypotension, renal failure, skull hypoplasia, and death in the fetus/neonate. Infants exposed to an ACE inhibitor in utero should be monitored for hyperkalemia, hypotension, and oliguria. Oligohydramnios may not appear until after irreversible fetal injury has occurred. Exchange transfusions or dialysis may be required to reverse hypotension or improve renal function, although data related to the effectiveness in neonates is limited.
Chronic maternal hypertension is also associated with adverse events in the fetus/infant. Chronic maternal hypertension may increase the risk of birth defects, low birth weight, premature delivery, stillbirth, and neonatal death. Actual fetal/neonatal risks may be related to duration and severity of maternal hypertension. Untreated chronic hypertension may also increase the risks of adverse maternal outcomes, including gestational diabetes, preeclampsia, delivery complications, stroke and myocardial infarction (ACOG 203 2019).
When treatment of hypertension in pregnancy is indicated, ACE inhibitors should generally be avoided due to their adverse fetal events; use in pregnant women should only be considered for cases of hypertension refractory to other medications (ACOG 203 2019). ACE inhibitors are not recommended for the treatment of heart failure in pregnancy (Regitz-Zagrosek [ESC 2018]).
When treatment is needed in females of reproductive potential with diabetic nephropathy, the ACE inhibitor should be discontinued at the first positive pregnancy test (Cabiddu 2016; Spotti 2018).
Kapuseal breastfeeding
Concentrations in human milk are approximately 1% of those in maternal blood.
AU and US: A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. UK: Use is not recommended for preterm infants and for the first few weeks after delivery. Use is considered acceptable in older infants only if clearly needed. Excreted into human milk: Yes Comments: The effects in the nursing infant are unknown.
See references
References for pregnancy information
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Capoten (Kapuseal)." Bristol-Myers Squibb, Princeton, NJ.
References for breastfeeding information
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Capoten (Kapuseal)." Bristol-Myers Squibb, Princeton, NJ.
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
References
- DailyMed. "CAPTOPRIL: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubMed Health. "Captopril (By mouth) (Capoten): This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhe... (accessed September 17, 2018).
- Human Metabolome Database (HMDB). "Captopril: The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body.". http://www.hmdb.ca/metabolites/HMDB0... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
