Captopril Contraindication in Pregnancy

Fetal Complications

• Renal dysgenesis (abnormal kidney development) can occur due to captopril use during pregnancy, as reported by the American Heart Association 1
• Other serious complications, including intrauterine growth retardation, hypotension in the newborn, patent ductus arteriosus, and intrauterine fetal death, can occur due to captopril use, as stated by the European Society of Cardiology 2

Regulatory Classification and Alternative Medications

• The FDA classifies captopril as Category D, indicating positive evidence of human fetal risk, but potential benefit may outweigh risk in life-threatening situations, as classified by the FDA and reported in the European Heart Journal 3
• The American College of Cardiology recommends methyldopa, labetalol, and nifedipine as first-line alternatives for hypertension in pregnancy, due to their established safety profiles, as recommended by the American Heart Association 4
• For women with heart failure or other conditions requiring ACE inhibitor therapy who become pregnant, alternative medications such as those recommended by the American College of Cardiology must be substituted, as advised by the European Society of Cardiology and the American Heart Association 5, 2