Cardiovascular system disorders
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Anticoagulant suggestions for adults with swallowing difficulties
5 November 2025A range of oral anticoagulant formulations are suitable for adults with swallowing difficulties.
Using heparins during breastfeeding
19 January 2024Low molecular weight heparin and unfractionated heparin can be used during breastfeeding. Recommendations apply to full term, healthy infants only.
Using antiplatelet medicines during breastfeeding
7 July 2023Antiplatelets can be used with caution in breastfeeding. Avoid exposure to aspirin if infant has a fever. Recommendations apply to full term, healthy infants.
Using beta-blockers during breastfeeding
9 August 2023Labetalol, metoprolol or propranolol are the beta-blockers of choice during breastfeeding. Recommendations apply to full term and healthy infants only.
Using calcium-channel blockers during breastfeeding
2 June 2023Nifedipine and verapamil are the calcium-channel blockers of choice during breastfeeding. Recommendations apply to full term and healthy infants only.
Using clopidogrel with proton pump inhibitors (PPIs)
14 September 2023Avoid the combined use of clopidogrel with omeprazole or esomeprazole due to a significant interaction. Other PPIs are considered safe with clopidogrel.
Using angiotensin-II receptor antagonists during breastfeeding
19 September 2023Very limited data suggest breastmilk levels are likely to be low, but other medicine classes are preferred. Recommendations apply to full term, healthy infants.
Identifying risk factors for developing a long QT interval
17 February 2026Some medicines (erythromycin, citalopram, ondansetron) can cause a long QT interval. Consider risk factors and follow MHRA recommendations for safe use.
Using ACE inhibitors during breastfeeding
2 June 2023Enalapril is the angiotensin converting enzyme (ACE) inhibitor of choice during breastfeeding. Recommendations apply to full term and healthy infants only.