PRESCRIBERS are being reminded of fetotoxic effects of candesartan and other angiotensin II receptor blockers (ARBs) following three reports in a year of fetal abnormalities.

The TGA said in one case fetal death occurred at 34 weeks, seven weeks after ceasing candesartan. In other cases the fetuses were diagnosed with renal failure, kidney malformation, nephrocalcinosis or congenital genitourinary system abnormalities.

In a safety update, the TGA said it had a total of four reports, including three from 2011, of abnormalities following candesartan use, and had similar reports linked to use of irbesartan, enalapril, lisinopril, perindopril and captopril during pregnancy.

Patients taking ARBs or ACE inhibitors, both classified as pregnancy category D, should be switched to alternative antihypertensives when planning pregnancy, the TGA said.

Medicines Safety Update, Vol 3 No 3 June 2012