To:   Patt Jamieson
Re:   Enalapril


VASOTEC
Generic  = ENALAPRIL MALEATE
Category = Antihypertensive,  ACE inhibitor
Enalapril is found in trace amounts in breastmilk although no untoward
effects have been reported. Enalapril is metabolized to an active metabolite
whose terminal half-life is 35-37 hours.   DO NOT use in pregnant women due
to increased  fetal and neonatal morbidity.   Infant would presumably
receive less than 0.1% of maternal dose.  The effect on infant has not been
determined.  Exercise caution when administering to lactating women,
although the data thus far indicates the levels secreted into milk are
clinically insignificant.   Observe infant for hypotension and bradycardia.
AAP Compatible with breastfeeding.
AHL= 3.4-5.8 hrs.             M/P=                              PB= 50%
PHL=                          PK = 0.5-1.5 hrs.



Enalapril is just another of the Angiotensin Converting Enzyme inhibitors
used as antihypertensives.  Of this family,  enalapril is one of the least
problematic for breastfeeding,  becuase its secretion into milk is minimal.
However,  any antihypertensive can reduce blood flow to the breast tissue,
and subsequently reduce breast milk production,   although this is not
always found.  It's highly variable.


Tom Hale