Use in women who are planning pregnancy should be avoided unless absolutely necessary, in which case the potential risks and benefits, should be discussed. On diagnosis of pregnancy, treatment with an ACE inhibitor or Angiotensin II receptor antagonist should be stopped as soon as possible, and, if appropriate, alternative treatment should be started.

The use of ACE inhibitors and angiotensin II receptor antagonists in late pregnancy has been associated with renal dysfunction, oligohydramnios, neonatal anuria, and other congenital anomalies such as skull ossification defects. However, data have also suggested an increased risk of congenital anomaly after exposure limited to the first trimester of pregnancy.

Further information: MHRA