Can I take candesartan while pregnant or breastfeeding?

8.1 Pregnancy Pregnancy Category D Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death. Resulting oligohydramnios can be associated with fetal lung hypoplasia and skeletal deformations. Potential neonatal adverse effects include skull hypoplasia, anuria, hypotension, renal failure, and death. When pregnancy is detected, discontinue candesartan cilexetil as soon as possible. These adverse outcomes are usually associated with use of these drugs in the second and third trimester of pregnancy. Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. Appropriate management of maternal hypertension during pregnancy is important to optimize outcomes for both mother and fetus. In the unusual case that there is no appropriate alternative to therapy with drugs affecting the renin-angiotensin system for a particular patient, apprise the mother of the potential risk to the fetus.

Prescribing label, section “8.1 Pregnancy” (opening excerpt): CANDESARTAN CILEXETIL (oral), Alembic Pharmaceuticals Limited. Read the full section on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.

Preliminary evidence suggests that candesartan passes poorly into milk and is barely detectable in the plasma of breastfed infants. Use of candesartan is not a reason to discontinue nursing, but use caution in newborn and preterm infants.

“Summary of Use during Lactation”, LactMed record “Candesartan” (LM727), quoted verbatim. Everything LactMed reports about Candesartan while breastfeeding.

Nursing Mothers It is not known whether candesartan is excreted in human milk, but candesartan has been shown to be present in rat milk. Because of the potential for adverse effects on the nursing infant, a decision should be made whether to discontinue nursing or discontinue candesartan cilexetil, taking into account the importance of the drug to the mother.

Prescribing label, section “Nursing Mothers”: CANDESARTAN CILEXETIL (oral), Alembic Pharmaceuticals Limited. Label on DailyMed. Quoted verbatim; US labels are written for US prescribers and patients.