Cardiovascular system disorders, Guidance

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Using antiplatelet medicines during breastfeeding

7 July 2023Antiplatelets can be used with caution in breastfeeding. Avoid exposure to aspirin if infant has a fever. Recommendations apply to full term, healthy infants.

Using beta-blockers during breastfeeding

2 June 2023Labetalol, metoprolol or propranolol are the beta-blockers of choice during breastfeeding. Recommendations apply to full term and healthy infants only.

Using calcium-channel blockers during breastfeeding

2 June 2023Nifedipine and verapamil are the calcium-channel blockers of choice during breastfeeding. Recommendations apply to full term and healthy infants only.

Using clopidogrel with proton pump inhibitors (PPIs)

22 May 2023Avoid the combined use of clopidogrel with omeprazole or esomeprazole due to a significant interaction. Other PPIs are considered safe with clopidogrel.

Using angiotensin-II receptor antagonists during breastfeeding

11 May 2023Very limited data suggest breastmilk levels are likely to be low, but other medicine classes are preferred. Recommendations apply to full term, healthy infants.

Using lipid-lowering medicines during breastfeeding

21 April 2023Rosuvastatin, pravastatin and atorvastatin are preferred; simvastatin and ezetimibe can also be used. Recommendations apply to full term and healthy infants.

Identifying risk factors for developing a long QT interval

29 March 2023Some medicines (erythromycin, citalopram, ondansetron) can cause a long QT interval. Consider risk factors and follow MHRA recommendations for safe use.

Using ACE inhibitors during breastfeeding

28 March 2023Enalapril is the angiotensin converting enzyme (ACE) inhibitor of choice during breastfeeding. Recommendations apply to full term and healthy infants only.

Using amlodipine or MR felodipine for angina and hypertension

13 March 2023Guidance on choosing and switching between amlodipine and modified-release (MR) felodipine for angina and hypertension.

Managing peripheral oedema caused by calcium channel blockers

26 September 2022All calcium channel blockers may cause peripheral oedema. There are different treatment options and the incidence can be affected by different factors.

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