ACE inhibitors

Alternate Names

Angiotensin-converting enzyme inhibitors

Definition

Angiotensin-converting enzyme (ACE) inhibitors are medicines that are used to treat heart, blood vessel, and kidney problems.

How ACE Inhibitors Help You

ACE inhibitors are used to help treat:

• Heart disease -- ACE inhibitors make your heart work less hard. This keeps some kinds of heart disease from getting worse. Most people who have heart failure take an ACE inhibitor.
• High blood pressure
• Strokes or heart attacks -- ACE inhibitors may help lower your risk of stroke or heart attacks.
• Diabetes and kidney problems -- ACE inhibitors help keep your kidneys from getting worse.

If you have these problems, ask your doctor if you should be taking these medicines.

Types of ACE Inhibitors

There are many different names and brands of ACE inhibitors. Most work as well as another. Side effects may be different for different ones.

• Benazepril (Lotensin)
• Captopril (Capoten)
• Enalapril (Vasotec)
• Fosinopril (Monopril)
• Lisinopril (Prinivil, Zestril)
• Moexipril (Univasc)
• Perindopril (Aceon)
• Quinapril (Accupril)
• Ramipril (Altace)
• Trandolapril (Mavik)

Taking Your ACE Inhibitors

ACE inhibitors are pills that you take by mouth. Take all of your medicines as your doctor told you to. Try to take them at the same time, or times, each day. Do not stop taking your medicines without talking with your doctor first.

Follow up with your doctor regularly. Your doctor will check your blood pressure. Your doctor will also do blood tests to check your kidneys and your potassium levels. Your doctor may change your dose from time to time.

Plan ahead so that you do not run out of medicine. Make sure you have enough with you when you travel.

Other important tips are:

• Before taking ibuprofen (Advil, Motrin) or aspirin, talk to your doctor.
• Tell your doctor what other medicines you are taking. This includes anything you bought without a prescription, diuretics (water pills), potassium pills, or herbal or dietary supplements.
• Do not take ACE inhibitors if you are pregnant or breast-feeding, or if you are planning to become pregnant. Call your doctor if you become pregnant when you are taking ACE inhibitors.

Side Effects

Side effects from ACE inhibitors are rare. Some are:

• You may have a dry cough. This may go away after a while. If it does not, tell your doctor. Sometimes reducing your dose helps. Do not reduce your dose without talking with your doctor first.
• You may feel dizzy or lightheaded when you start taking ACE inhibitors, or if your doctor increases your dose. Standing up slowly from a chair or your bed may help. If you have a fainting spell, call your doctor right away.

Some other side effects are:

• Headache
• Feeling tired
• Loss of appetite
• Upset stomach
• Diarrhea
• Numbness
• Fever
• Skin rashes or blisters
• Joint pain

If your tongue or lips swell, call your doctor right away, or go to the emergency room. You may be having a serious allergic reaction to the medicine. This is very rare.

When to Call the Doctor

Call your doctor if you are having any of the side effects above, or if you are having other unusual symptoms.

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References

American Academy of Family Physicians. ACE Inhibitors Effective in Patients with CAD Without Heart Failure.American Family Physician. 2006 Sept 1. Accessed November 10, 2008.

American Diabetes Association. Standards of medical care in diabetes -- 2010. Diabetes Care. 2010; 33 Suppl 1:S11-S61.

Morrow, DA, Gersh BJ. Chronic coronary artery disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 54.

Bernard J. Gersh

Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG, et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009 Apr 14;119(14):1977-2016. Epub 2009 Mar 26.