ACE Inhibitors / Women of Childbearing age

[luceeloo]

I have had a message from my Dr's surgery today telling me that the Nurse has decided that as my blood pressure is borderline, I should call in and pick up a prescription for Lisinopril today and start taking it right away. They've made an appointment for me in 2 weeks time to assess how I'm getting on.

Only because I was reading various bits and pieces on the NICE website a few weeks ago that I remember reading that there are serious questions over the safety of using ACE inhibitors in women who are of child bearing age and that the side effects should be clearly outlined to the patient.
I'm 33, getting married next year, and we plan on trying for children shortly after that. However, we are not particularly using any preventative methods now.
Neither my Dr or the Nurse have mentioned the side effects of the tablets, or in fact really discussed much about taking medication for blood pressure.

I feel like throwing the prescription back at them!! Does anyone else take Lisinopril? Any women of childbearing age have experience of taking ACE inhibitors?
I really don't know what to do - whether to start taking them for the next fortnight until I can see the nurse again, or just not bother and tell them to sort something else out?

 

[phoenix]

I definitely think that you should contact her and ask for an alternative, going armed with the reasons why.
High blood pressure is also not a good idea during pregnancy so just ignoring it is probably not best either.

From what I can see from a very quick search ACES don't actually seem to cause a problem before and in the early stages of pregnancy but are definitely contraindicated in the 2nd two trimesters. If you aren't using contraceptives then it makes absolute sense not to use one if you might become pregnant.

If you are pregnant, breastfeeding or planning a pregnancy, you should not be given an ACE inhibitor

http://www.bloodpressureuk.org/BloodPressureandyou/Medicines/Medicinetypes/ACEInhibitors

New Zealand Guidelines

ACE inhibitors need not be contraindicated in women of childbearing potential, but women intending to become pregnant should switch from an ACE inhibitor in anticipation. A contraindication applies after the first trimester

http://www.medsafe.govt.nz/profs/PUarti ... indication

Use of ACE inhibitors and ARBs in hypertensive women of childbearing age (2008)

Many GPs continue to prescribe ACE inhibitors and ARBs to women of childbearing age. A quarter of women in the study were taking these agents and were 40 years or less; of these many were not using reliable contraception. These women are at risk of foetal malformation and poor perinatal outcomes if they become pregnant. .

http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract

Welsh medicines resource centre

ACE inhibitors and ARBs are contraindicated in pregnancy. A medicine from a different class is preferred in women who may want to have children

.
http://www.wemerec.org/Documents/Bullet ... in2012.pdf

NICE evidence database
https://www.evidence.nhs.uk/search?q=ac ... nancy&pa=2

 

[luceeloo]

Phoenix, thank you for your information.

I have decided to make an appointment to discuss it further with a GP at the practice. I spoke in length to my partner last night, who is as unhappy for me to take these as I am.