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ACE inhibitors

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

Alternative names

Angiotensin-converting enzyme inhibitors

How ACE inhibitors help

ACE inhibitors are used to treat heart disease. These medicines make your heart work less hard by lowering your blood pressure. This keeps some kinds of heart disease from getting worse. Most people who have heart failure take these medicines.

These medicines treat high blood pressure, strokes, or heart attacks. They may help lower your risk for stroke or heart attack.

They are also used to treat diabetes and kidney problems. This can 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.

Taking your ACE inhibitors

ACE inhibitors are pills that you take by mouth. Take all of your medicines as your doctor told you to. Follow up with your doctor regularly. Your doctor will check your blood pressure and do blood tests to make sure the medicines are working properly. Your doctor may change your dose from time to time. In addition:

  • Try to take your medicines at the same time(s) each day.
  • Do not stop taking your medicines without talking to your doctor first.
  • Plan ahead so that you do not run out of medicine. Make sure you have enough with you when you travel.
  • Before taking ibuprofen (Advil, Motrin) or aspirin, talk to your doctor.
  • Tell your doctor what other medicines you are taking, including anything you bought without a prescription, diuretics (water pills), potassium pills, or herbal or dietary supplements.
  • Do not take ACE inhibitors if you are planning to become pregnant, pregnant, or breastfeeding. Call your doctor if you become pregnant when you are taking these medicines.

Side effects

Side effects from ACE inhibitors are rare.

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. But sometimes your doctor will switch you to a different medication. Do not lower your dose without talking with your doctor first.

You may feel dizzy or lightheaded when you start taking these medicines, 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.

Other side effects include:

  • Headache
  • Fatigue
  • 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 listed above. Also call your doctor if you are having any other unusual symptoms.

References

Mant J, Al-Mohammad A, Swain S, Laramée P; Guideline Development Group. Management of chronic heart failure in adults: synopsis of the National Institute for Health and Clinical Excellence guideline. Ann Intern Med. 2011 Aug16;155(4):252-9.

Januzzi JL, Mann DL. Clinical assessment of heart failure. In: Mann DL, Zipes DP, Libby P, et al. eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Saunders Elsevier; 2014:chap 23.

Ridker PM, Libby P, Buring JE. Risk markers and the primary prevention of cardiovascular disease. In: Mann DL, Zipes DP, Libby P, et al. eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Saunders Elsevier; 2014:chap 42.

Riegel B, Moser DK, Anker SD, et al; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009 Sep 22;120(12):1141-1163.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013 Oct 15;128(16):e240-327. Epub 2013 Jun 5.

Updated: 8/12/2014

Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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