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    ACE inhibitors

    Angiotensin-converting enzyme inhibitors

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

    How ACE Inhibitors Help You

    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 also are 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. 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 make sure the medicines are working properly. 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 breastfeeding. Do not take these medicines if you are planning to become pregnant. 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.

    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. Also call your doctor if you are having 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.

    Greenberg B and Kahn AM. Clinical assessment of heart failure. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald'sHeart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Saunders; 2011:chap 26.

    Gaziano M, Ridker PM, Libby P. Primary and secondary prevention of coronary heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald'sHeart Disease: A Textbook of Cardiovascular Medicine. 9th ed.Saunders; 2011:chap 49.

    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, PhysicalActivity, 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):1141-63.

    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.

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            Review Date: 8/5/2012

            Reviewed By: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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