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Patient Instructions

Angiotensin-converting enzyme (ACE) inhibitors open blood vessels and decrease the heart’s workload. They treat high blood pressure but can also help protect the heart and kidneys.

If you have diabetes, heart failure, heart disease, or high blood pressure, ask your doctor if you should be taking ACE inhibitors.

They are used to help treat these health problems:

• Heart disease -- ACE inhibitors reduce the amount of work your heart has to do. This keeps some kinds of heart disease from getting worse. Most people who have heart failure take an ACE inhibitor.
• Diabetes and kidney problems -- ACE inhibitors help keep your kidneys from getting worse.
• Strokes or heart attacks -- ACE inhibitors may help lower your risk of having strokes or heart attacks, if you already have had these problems.

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

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 and 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:

• Do not take ibuprofen (Advil, Motrin) or aspirin if you are taking ACE inhibitors.
• 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, or if you are planning to become pregnant. Call your doctor if you become pregnant when you are taking ACE inhibitors.

Side effects from ACE inhibitors are rare. Some of them 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
• Tiredness
• Loss of appetite, upset stomach, or 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.

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

Angiotensin-converting enzyme inhibitors

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 -- 2008. Diabetes Care. 2008 Jan;31 Suppl 1:S12-54.

Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J, et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007 Dec 4;116(23):2762-72. Epub 2007 Nov 12.

Hunt SA‘ American College of Cardiology; American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol. 2005 Sep 20;46(6):e1-82

Updated by: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.