Exposure to amlodipine in the first trimester of pregnancy and during breastfeeding.
OBJECTIVE
To assess the fetal outcome of three hypertensive women exposed to amlodipine. 5 mg/day, in the first trimester of pregnancy. CASE 1: The patient was treated with amlodipine until 7 weeks of gestation. She was also exposed to levosulpiride, aluminum hydroxide gel, magnesium carbonate, and Ginkgo biloba. At 38(+3) weeks of pregnancy, she delivered a 3750 g healthy female baby, and restarted taking amlodipine, 5 mg/day, while exclusively breastfeeding her daughter. At three months of age, the infant was healthy. CASE 2: The patient was treated with amlodipine from 2(+2) to 3(+4) weeks of pregnancy. Her treatment was modified to atenolol until the week 6(+4 weeks), when she declined any antihypertensive treatment. At 39(+4) weeks of pregnancy, the patient delivered a 2600 g baby. At 20 months old, the baby presented with intellectual delay and weakness in the left arm and hand grasp. These neurological alterations were not attributed to her exposure to amlodipine early in utero. CASE 3: The patient was treated with amlodipine from 7(+6) to 12 weeks of pregnancy. She was also taking sucralfate and lorazepam. At 12 weeks of amenorrhea, ultrasound revealed a 15.3 mm, single fetal pole in the gestational sac without cardiac activity. She underwent dilatation and evacuation of a dead embryo.


CONCLUSIONS
As reported with other calcium-channel blockers, amlodipine does not appear to be teratogenic and it appears to be compatible with breastfeeding.
Ahn
Hyun Kyong
HK
The Korean Motherisk Program, Cheil Hospital & Women's Health-care Center, Kwandong University School of Medicine, Seoul, Korea.
Nava-Ocampo
Alejandro A
AA
Han
Jung Yeol
JY
Choi
June Seek
JS
Chung
Jin Hoon
JH
Yang
Jae Hyug
JH
Koong
Mi Kyoung
MK
Park
Chong Taik
CT
D000328:Adult; D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D001942:Breast Feeding; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D005260:Female; D047109:Fetal Development / Q000187:drug effects*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D017311:Amlodipine