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Drugs & Supplements

Angiotensin Converting Enzyme (ACE) Inhibitors

Medication Names
  • captopril (Capoten®)
  • enalapril (Vasotec®)
  • lisinopril (Prinivil, Zestril®)
  • quinapril (Accupril®)
  • fosinopril (Monopril®)
  • trandolapril (Mavik®)
  • ramipril (Altace®)
Why this medication is prescribed

An ACE inhibitor is a type of vasodilator that dilates (widens) the blood vessels to improve the amount of blood the heart pumps. An ACE inhibitor also increases blood flow, which will help decrease the amount of work the heart has to do and may also decrease your blood pressure.

An ACE inhibitor also prevents the production of harmful substances (angiotensin II) that are produced as a result of heart failure.

An ACE inhibitor is a core therapy in treating systolic heart failure. Systolic dysfunction occurs when the heart muscle doesn’t contract with enough force, decreasing the amount of oxygen-rich blood pumped throughout the body.

An ACE inhibitor may be prescribed for the treatment of heart failure with preserved left ventricular function (diastolic dysfunction). This condition occurs when the heart contracts normally, but the left ventricle doesn’t relax properly so less blood enters the heart. Your doctor can discuss which condition is present in your heart.

When to take

This medication is usually taken on an empty stomach one hour before meals. Follow the label directions on how often to take this medication. The number of doses you take each day, the time allowed between doses, and how long you need to take the medication will depend on the type of ACE inhibitor prescribed, as well as your condition.

Special directions

While taking this medication, have your blood pressure and kidney function checked regularly, as advised by your health care provider.

Do not stop taking your medication, even if you feel that it is not working. Your heart failure symptoms may not improve right away when taking an ACE inhibitor. However, long-term use of an ACE inhibitor helps manage chronic heart failure and reduces the risk that your condition will become worse.

Food and drug interactions

While taking an ACE inhibitor medication, do not use salt substitutes--they contain potassium and ACE inhibitor medications cause the body to retain potassium. Learn how to read food labels so that you can choose low-sodium and low-potassium foods. A dietitian can help you select low-sodium and low-potassium foods.

Over-the-counter nonsteroidal anti-inflammatory medications (like ibuprofen or naproxen) and aspirin may cause the body to retain (keep) sodium and water, and decrease the effect of an ACE inhibitor. Check with your health care provider before taking any anti-inflammatory medications.

Side effects and how to manage them
  • Red, itchy skin rash - Contact your doctor or nurse; do not treat the rash yourself.
  • Dizziness, lightheadedness, or faintness when you get out of bed or rise from a chair - This side effect may be strongest after the first dose, especially if you have been taking a diuretic (water pill). Get up more slowly. Contact your doctor or nurse if these symptoms persist or are severe.
  • Salty or metallic taste; decreased ability to taste - This effect usually goes away as you continue taking the medication.
  • New or worsening cough - Use hard candy (sugarless) to help moisten your throat and control the cough. If the coughing prevents you from sleeping at night, persists for more than 6 months, or is severe, contact your doctor or nurse.
  • Sore throat; fever; mouth sores; unusual bruising; fast or irregular heartbeat; chest pain; swelling of feet, ankles, lower legs - Contact your doctor or nurse.
  • Swelling of your neck, face, tongue, or lips - Contact your doctor or nurse right away.
  • Signs of too much potassium in the body: confusion; irregular heartbeat; nervousness; numbness or tingling in hands, feet, or lips; shortness of breath or difficulty breathing; weakness or heaviness in legs - Contact your doctor or nurse right away.
  • If you become sick with severe vomiting or diarrhea, you may become dehydrated, which can lead to low blood pressure - Contact your doctor or nurse.

Also contact your doctor or nurse if you have any other symptoms that cause concern.

Sources

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/12/2010...#12861