Lisinopril in Pregnancy — Is It Safe?
Last reviewed: · Source: US FDA drug label database
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Lisinopril must be stopped in pregnancy — all ACE inhibitors damage fetal kidneys and should be switched to a safe blood pressure alternative as soon as possible.
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Is it safe to take Lisinopril with Pregnancy?
Lisinopril, like all ACE inhibitors, is contraindicated in pregnancy. Exposure in the second and third trimesters causes fetal kidney failure, oligohydramnios, pulmonary hypoplasia, skull bone defects, and can be fatal to the baby. First-trimester exposure is less clearly harmful than once thought, but prompt switching is still essential. Standard pregnancy alternatives for blood pressure include labetalol, nifedipine, and methyldopa.
How do Lisinopril and Pregnancy interact?
ACE inhibition blocks the renin-angiotensin system that drives fetal urinary output from the second trimester. Fetal oliguria → oligohydramnios → pulmonary hypoplasia, limb contractures, craniofacial abnormalities. FDA boxed warning for all ACE inhibitors in pregnancy.
Data sourced from the US Food and Drug Administration (FDA) drug label database: FDA boxed warning — ACE inhibitor fetal toxicity.
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All women of childbearing age on ACE inhibitors should have a pre-conception plan. Pregnancy on an ACE inhibitor requires prompt switching — this week, not at the next routine appointment.
What if I've already taken Lisinopril and Pregnancy?
Contact your GP within days. A safe alternative will be prescribed. Blood pressure still needs controlling — do not stop without replacement.
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Frequently Asked Questions
Can I take lisinopril while pregnant?
No — switch to a safe alternative immediately. Labetalol, nifedipine or methyldopa are the standard options.
What blood pressure medicine is safe in pregnancy?
Labetalol is usually first-line; modified-release nifedipine and methyldopa are alternatives. All chosen with obstetric team input.
I became pregnant while on lisinopril — what do I do?
See your GP this week. The risk is greatest from second trimester onwards; prompt switching greatly reduces fetal risk.
Can I restart lisinopril after delivery?
Yes — ACE inhibitors can be restarted postnatally. Some (enalapril) are considered compatible with breastfeeding.