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Am Fam Physician. 2002;66(3):473

What are ACE inhibitors?

ACE inhibitors are medicines that were first designed to treat high blood pressure. They are safe and have few side effects. There are several different brand names.

What health problems do ACE inhibitors help with?

ACE inhibitors can help with several health problems:

  • High blood pressure—lowers blood pressure by relaxing blood vessels

  • Heart failure—helps the heart pump more easily

  • Heart attack—better healing of the heart after a heart attack

  • Kidney disease—slows kidney damage in people with diabetes

  • Atherosclerosis (hardening of the arteries)—fewer strokes and heart attacks

Can everyone take ACE inhibitors?

ACE inhibitors are safe for most people, but not for everyone. The following are people who shouldn't take ACE inhibitors:

  • Pregnant women. An ACE inhibitor might hurt the baby during the last six months of pregnancy. If you were already taking an ACE inhibitor and stop taking it during the first three months of pregnancy, the risk to your baby is very low. Your doctor can give you other medicines that are safe to use during pregnancy.

  • People with severe kidney failure. If you have this problem, an ACE inhibitor may not be safe for your kidneys. Your kidney function would have to be closely watched. Your doctor will know if you have this problem.

  • People who have ever had a severe allergic reaction that caused their tongue and lips to swell, even if it was from a bee sting, should not take ACE inhibitors. If you have this reaction to the medicine, go to the hospital right away.

What are some of the side effects of ACE inhibitors?

ACE inhibitors have a few side effects that only happen in some people:

  • Dry cough can occur in about one in 10 people. Sometimes this even happens after they have been taking the medicine for months. If you have a cough and it makes you too uncomfortable, talk to your doctor. You might be able to try another kind of ACE inhibitor. A different brand of this medicine might not make you cough.

  • Dizziness can happen with the first or second dose. If the dizziness is severe, do not take any more ACE inhibitors and call your doctor right away. Usually, the dizziness goes away after a while.

  • Over-the-counter medicines can affect ACE inhibitors. You should not take ibuprofen (brand name: Advil) or naproxen sodium (brand name: Aleve). These medicines make ACE inhibitors less effective.

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