Enara-5/Enara-20 Use In Pregnancy & Lactation

Pregnancy: Pregnancy category: D.
Fetal and neonatal morbidity and mortality have been reported in at least 50 pregnant women who were receiving ACE inhibitors during pregnancy. Enalapril act on the renin angiotensin system can cause injury and death to developing fetus. Enalapril crosses the placenta, teratogenic effects may occur following maternal use during pregnancy. Drug are associated with oligohydramnios, due to decreased fetal renal function may lead to fetal lung hypoplasia and skeletal malformations. The use of these drug in pregnancy is also associated with anuria, hypotension, renal failure, skull hypoplasia and death in the fetus/neonate. ACE inhibitors are not recommended during pregnancy to treat maternal hypertension or heart failure. Woman who are planning a pregnancy should be considered for other medication option if an ACE inhibitor is currently prescribed or the ACE inhibitor should be discontinued as soon as possible once pregnancy is detected.
Lactation: Because enalapril is distributed into human milk and potentially may cause serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or enalapril.