Here is some information about ramipril:
It is only 50-60% absorbed from the gi tract (both baby's and mother's).
The absolute bioavailability of ramipril and ramiprilat (it's principal
metabolite and active ingredient) is 28 and 44% respectively.
Its metabolism is quite complex and the final answer is not in, though,
I think it is probably safe for breastfeeding.
But then, why not use captopril, which we use for small infants, which
we know is safe for breastfeeding and functions exactly as does ramipril
(angiotensin converting enzyme inhibitor)?
Jack Newman, MD, FRCPC