To:  Toni
Re:  Univasc (Moexipril)


To echo my colleagues, moexipril is a prodrug that is metabolized to an
active ACE inhibitor.  While this product may turn out to be an ideal ACE
inhibitor for Bfing moms in the future, we do not have such data now.  Oral
bioavailability is low, only 13%, and its half life varies from 2-10 hours.

But why not use those we have data on, and are believed safer...such as
Captoril(Capoten), enalapril(Vasotec), or perhaps Benazepril(Lotensin).

Why all this concern,  the ACE inhibitors are somewhat risky when used in
the perinatal period, especially prior to delivery.  The ACE inhibitor
family can produce profound and dangerous hypotension in newborns, so we are
more cautious of their use during the prenatal, or early postnatal periods.
This is why it is given a Pregnancy Risk category of X during the last
trimester.


Regards
Tom Hale, Ph.D.