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Hydralazine Vasodilator C Yes Yes (1%)b • maternal side effects: lupus-like symptoms, foetal tachyarrhythmia • see also section 10 on hypertensive disorders Animal data: • teratogenic in mice (20–30 MRHD) and rabbits (10–15 MRHD): cleft palate, malformations of facial and cranial bones • no teratogenicity in rats Hydrochlorothiazide Diuretic (thiazide) B Yes Yes; milk production can be reduced

Oligohydramnios • impaired foetal–placental perfusion, foetal and neonatal effects like icterus, dis- turbance of electrolyte balance, and thrombocytopenia Iloprost Prostacyclin analogue C Unknown Unknown Inadequate human data • use only when benefit outweighs risk Animal data:- rats: shortened digits of the thoracic extremity in foetuses and pups at a dosage of 0.01 mg/kg/day in Han-Wistar rats (these alterations are considered to be haemodynamic alterations in the fetoplacental unit and not teratogenic) No such digital anomalies or other gross structural abnormalities in Sprague- Dawley rats or monkeys In Sprague-Dawley rats, iloprost clathrate (13% iloprost) significantly increased the number of non-viable foetuses at a maternally toxic oral dosage of 250 mg/kg/day, and in Han-Wistar rats it was found to be embryolethal in 15 of 44 litters at an i.v. dosage of 1 mg/kg/day Indapamide Diuretic (thiazide) B Yes Unknown Inadequate human data • use only when benefit outweighs risk Animal data: • no evidence of impaired fertility or foetal harm in rats, mice, or rabbits (6.25 RHD), and unaffected post-natal development in rats and mice Isosorbide dinitrate Nitrate B Unknown Unknown Bradycardia Animal data: • dose-related increase in embryotoxicity (excess mummified pups) in rabbits at 70 mg/kg (12 MRHD) Isradipine Calcium channel

blocker C Yes Unknown Inadequate human data

• potential synergism with magnesium sulfate may induce hypotension Animal data: • in rats and rabbits, significant reduction in maternal weight gain; no teratogenic- ity (up to 150 MRHD) Continued Downloaded from academic.oup.com/eurheartj/article/39/34/3165/5078465 by guest on 07 October 2026