What is the preferred antihypertensive medication in pregnant women?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Although reducing maternal risk is the goal of treating chronic hypertension in pregnancy, it is fetal safety that largely directs the choice of antihypertensive agent. Methyldopa is generally the preferred first-line agent because of its safety profile. [5] Other drugs that may be considered include labetalol, beta-blockers, and diuretics. Data are limited regarding the use of clonidine and calcium antagonists in pregnant women with chronic hypertension; however, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor (ARB) antagonists should be avoided because of the risk of fetal toxicity and death. [5]

For further information, see the Medscape Drugs & Diseases articles Hypertension and Pregnancy, Preeclampsia, and Eclampsia.


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