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ACE inhibitors in pregnancy — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsACE inhibitors in pregnancyGPhC CRA

A 31-year-old woman who is 10 weeks pregnant brings a repeat prescription for ramipril 5mg daily. She says she has taken it for hypertension for several years and has not yet spoken to her GP since the positive pregnancy test. What is the most appropriate alternative?

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

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Correct answer: A — Refer promptly for a pregnancy-suitable antihypertensive review

ACE inhibitors should be avoided in pregnancy because of fetal risk, particularly in later pregnancy, and treatment should be reviewed promptly. Suitable alternatives may include labetalol, nifedipine or methyldopa depending on the patient. The pharmacist should not choose and start a replacement independently from a community prescription query.

Reference: BNF; NICE CKS