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ACE inhibitor in pregnancy — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsACE inhibitor in pregnancyGPhC CRA

A 32-year-old woman taking lisinopril for hypertension tells you she has had a positive pregnancy test. She feels well and has enough tablets at home. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Advise urgent prescriber review because ACE inhibitors should be stopped in pregnancy

ACE inhibitors are contraindicated in pregnancy because of fetal renal and other risks, particularly later in pregnancy. She should be referred promptly for a safer antihypertensive alternative such as labetalol, nifedipine or methyldopa depending on suitability. Abrupt unmanaged cessation is not ideal, but continued use without urgent review is unsafe.

Reference: BNF; NICE CKS