High blood pressure
Alpha-methyldopa, a relatively old and proven antihypertensive (blood pressure reducer), is the drug of choice as a blood pressure reducer in pregnancy and lactation. Certain beta-blockers such as metoprolol are also considered to be the drug of choice for high blood pressure during breastfeeding. Older ACE inhibitors such as captopril, enalapril or benazepril can be taken when breastfeeding if first-choice antihypertensives (such as methyldopa, metoprolol) are not effective or contraindicated.
Diuretics such as thiazide diuretics (HCT) appear to be relatively well tolerated at low doses during lactation. Higher doses, which lead to increased water loss through urine, may reduce milk production. For example, hydrochlorothiazide was previously used for weaning. Among the calcium antagonists, nifedipine or nitrendipine are preferred.
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