Summary of Use during Lactation

Because of the low levels of lisinopril in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants.

Drug Levels

Maternal Levels. Five women who were taking lisinopril and had donated milk samples to a breastmilk repository had their milk analyzed for lisinopril. Milk samples were collected under steady-state conditions at time intervals of 0, 1, 2, 4, 6, 8, 10, 12, and 24 hours after a dose. One woman was taking 5 mg daily, and two each were taking 10 and 20 mg daily. Milk lisinopril measurements were adjusted (doubled or halved) to a standard 10 mg daily dosage. The peak concentration of lisinopril was 0.63 mcg/L and occurred at an average of 4 hours after the dose. The average lisinopril concentration was 0.49 mcg/L, which corresponds to an infant daily dose of 0.073 mcg/kg daily and a relative infant dose of 0.06%.[1]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Five women who were taking lisinopril reported any perceived adverse effects in their infants. Four taking doses of 5, 10 and 20 mg daily reported no adverse effects in their infants. One had taken 5 mg of lisinopril daily and breastfed her 1-year-old since birth, exclusive probably through 6 months and extensively thereafter. The fifth women reported that her infant’s “poop smelled unpleasant and was often green”, but she continued breastfeeding and taking lisinopril.[1] It is not clear if the infant’s condition was related to lisinopril.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

Benazepril, Captopril, Enalapril, Quinapril

References

1.

Chugh J, Dai J, Datta P, et al. Investigating the transfer of lisinopril into human milk: A quantitative analysis. J Cardiovasc Pharmacol 2025;85:84-7. [PubMed: 39405564]

Substance Name

Lisinopril

CAS Registry Number

83915-83-7

Drug Class

Breast Feeding

Lactation

Milk, Human

Antihypertensive Agents

Angiotensin-Converting Enzyme Inhibitors

ACE Inhibitors

ACEIs