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Am Fam Physician. 2002;66(11):2048

to the editor: I would like to suggest two additions to the American Family Physician patient information handout on angiotensin-converting enzyme (ACE) inhibitors.1 First, angioedema is a rare but potentially fatal complication of ACE inhibitor use. All persons who use ACE inhibitors should be informed of this side effect, which may occur more commonly in blacks. Second, more emphasis should be placed on exercising caution with the use of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs may cause serious, potentially life-threatening hyperkalemia, especially in older patients who are the patients most likely to use both of these classes of drugs. It is important for physicians to educate their patients who are receiving ACE inhibitors about avoidance of over-the-counter NSAIDs.

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