Angiotensin-Converting Enzyme (ACE) Inhibitors

What the treatment is and why it's prescribed

ACE inhibitors treat a variety of conditions, such as high blood pressure, scleroderma and migraines.

Angiotensin-converting enzyme (ACE) inhibitors help relax blood vessels by preventing an enzyme in your body from producing angiotensin II, a substance in your body that narrows your blood vessels and releases hormones.

Examples of ACE inhibitors

Many ACE inhibitors are available. Which one is best for you depends on your health and the condition being treated. According to research, black and older people respond less well to ACE inhibitors than do white and younger people.

Examples of ACE inhibitors include:

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

Before taking treatment

When taking ACE inhibitors, it is important that you tell your doctor, nurse or pharmacist about any other medicines you are taking. This includes medicines on a prescription from your GP, medicines bought from a pharmacy (chemist) or any homeopathic or herbal medicines.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, should not be taken alongside ACE inhibitors. Certain types of diuretics (water tablets) should be taken with care.

If your doctor decides to stop treatment with ACE inhibitors, return any unused tablets to the pharmacist. Do not flush them down the toilet or throw them away.

If an adult or a child taking the treatment vomits within a short time of taking a dose and you are able to see the tablet in the vomit, then give the dose again. If you cannot see the tablet, do not give it again.

If you forget a dose, give the next dose as scheduled and try to keep to a regular routine.

For children, in certain circumstances, medicines may be prescribed for a child outside the age range recommended by the manufacturer. Medicines are often used 'off licence' in children because trial data is not available for a specific use, for example, age. Please discuss this with your doctor.

How long you take it and long it takes to work

ACE inhibitors are usually taken once daily. Your doctor would tell you how long you will need to take it.

What are the possible risks or side-effects?

Doctors commonly prescribe ACE inhibitors because they don't often cause side effects.

Possible ACE inhibitor side effects include:

  • Dry cough
  • Increased blood-potassium level (hyperkalemia)
  • Fatigue
  • Dizziness
  • Headaches
  • Loss of taste

In rare cases — but more commonly in black people and in smokers — ACE inhibitors can cause some areas of your tissues to swell (angioedema). If it occurs in the throat, the swelling can be life-threatening.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), decrease the effectiveness of ACE inhibitors. Taking an occasional dose of these medications shouldn't change the effectiveness of your ACE inhibitor, but talk to your doctor if you regularly take NSAIDs.

Can this treatment affect fertility, pregnancy or breastfeeding?

Because ACE inhibitors can cause birth defects, talk to your doctor about other options of treatment if you're pregnant or you plan to become pregnant.

How to store treatment

Keep tablets in a safe place where children cannot see or reach them.

Whilst it's important you understand that taking medicine may have side effects, the benefits of taking the right medication may outweigh these. Do speak to your GP about any concerns you may have or contact our helpline to discuss your condition.

Why not contact people who have the same conditions and have used ACE Inhibitors, join our Facebook and Twitter groups and ask a question or on our Health Unlocked.

Raynaud's attacks can be restricted if you can keep your core temperature warm. Read our managing Raynaud's page or visit the shop to view products to help prevent your Raynaud's attacks, as recommended by our community.

Information sourced from the NHS and the Mayo clinic.