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REFLECTIONS
Dyslipidaemia
Dyslipidaemia Global Newsletter #8 2024

The authors highlight that there are unique considerations to the fetus. Bempedoic acid is a newer lipid-lowering agent
for pharmacotherapy during preconception, pregnancy, and that is not recommended for use during pregnancy. There is
lactation. Many lipid-lowering medications are contraindicated limited experience with PCSK9i during pregnancy and they
Dyslipidaemia
or require careful risk-benefit assessment in these contexts. The should be used with caution. The safety of omega-3 fatty
authors highlight that prepregnancy counselling is important, acids in pregnancy women to treat lipid disorders remains
especially in more high-risk patients. unclear; therefore, it should be used with caution both in
pregnancy and during lactation. Fibric acid derivatives also are
Statins are generally recommended to be avoided in women cautioned for use during pregnancy and in lactating woman.
trying to conceive and during pregnancy, but since the FDA It is recommended to wait five days after the final dose before
removed the contraindication for statins during pregnancy resuming breastfeeding. Given the lack of CVD benefit and
in July 2021, they may be considered for high-risk women, potential increased risk, niacin is no longer used as a treatment
such as those with a history of ASCVD, HoFH, or severe for lipid management for ASCVD prevention.
heterozygous FH. Bile acid sequestrants are not absorbed
systemically, making them a safer option for lowering LDL-C Lipoprotein apheresis is approved during pregnancy and
levels during pregnancy and lactation. Ezetimibe should only considered safe for very high-risk women with known significant
be considered if the potential benefits justify the potential risk ASCVD or HoFH.

Safety profile of lipid-lowering pharmacotherapies in pregnancy and lactation

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