Pregnancy, breastfeeding and fertility while taking ramipril

Ramipril and pregnancy

Ramipril is not recommended in pregnancy. It can affect your baby's kidneys, especially if it's taken in the second and third trimesters of pregnancy. This can result in long term damage to your baby's kidneys.

If you're already pregnant, stop taking ramipril and talk to your doctor straight away. Usually your doctor will be able to prescribe a different medicine that is safe to take in pregnancy. Ramipril should be stopped by the time you're 12 weeks pregnant at the latest.

Use contraception if you're taking ramipril and carefully plan any pregnancy with your GP, pregnancy specialist (obstetrician) or hospital doctor. They will want to review your medical condition and medicine before you get pregnant.

Most women stop taking ramipril before getting pregnant, but some may continue until they have a positive pregnancy test and then stop. Your doctor will discuss what's best for you, based on your medical condition and the risks and benefits of ramipril.

Ramipril and breastfeeding

It might be OK to take ramipril while breastfeeding, but talk to your doctor or pharmacist first. It's best not to take ramipril if your baby was born prematurely, but your doctor will help you decide.

It's not yet known how much ramipril passes into breast milk, but it's likely to be a small amount. It is unlikely to cause side effects in your baby. However, there is a very small risk that it could also lower your baby's blood pressure. Your doctor might recommend a different medicine for you to take while breastfeeding.

If you notice that your baby is not feeding as well as usual, seems unusually sleepy, seems much paler than usual, or if you have any other concerns about your baby, talk to your health visitor, midwife or doctor as soon as possible.

Ramipril and fertility

There's no clear evidence to suggest that taking ramipril reduces fertility in either men or women.

But if you're trying to get pregnant, talk to your doctor first as this medicine is not recommended in pregnancy.

For more information about how ACE inhibitors such as ramipril can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.