Lisinopril is what is known as an ACE inhibitor. A healthy body takes ACE I
(an enzyme) and converts it to ACE II. ACE II causes constriction of blood
vessels, which increases blood pressure. If you use an ACE inhibitor, it
prevents the conversion of ACE I to ACE II, and keeps the blood vessels
dilated. (Think about a 1/2" hose with 5 gallons per minute of water running
through it, and then imagine a hose with twice that diameter - the smaller
diameter has greater pressure.)

Not knowing what kind of cardiomyopathy these mothers have, there may be
good reasons for ACE inhibitors, and it is possible the doctor might
consider using a med that is better tested, such as enalapril. This is an L2
med, and the AAP considers it, "Usually compatible with breastfeeding." 

Depending on the condition, the doctor might consider beta blockers (these
drugs end in -lol, like propranolol, or metoprolol) (ACE inhibitors usually
end in -pril). Propranolol is an L2, "Usually compatible with breastfeeding
- AAP - med. Metoprolol is an L3, but is considered "usually compatible."

Hope this helps!

Best wishes,
Sam Doak


We're going to Candy Mountain, Charlie!


Hi,

In the course of 2 weeks, I have worked with 2 separate moms who have been 
diagnosed with cardiomyopathy and placed on lisiniprol. This is an L3 drug
in 
Hale's book and has not had good research. Each baby has the same 
pediatrician. One baby is a NICU baby, 36 weeks. The other has a 2-month
old.

I am wondering if there are any physicians on LACTNET who have successfully 
followed breastfed infants whose mothers are using this medication, and seen

good outcomes. The pediatrician has asked me to inquire. She is very 
supportive of breastfeeding, but also reluctant to give the breastmilk if
the 
infants will become hypotensive. 

Thank you!!

Brenda Phipps, BS, IBCLC

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