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ACE Inhibitors

E.g. Ramipril, enalapril, lisinopril, perindopril

What do ACE Inhibitors do?

How do I take them?

Side effects

What do ACE Inhibitors do?

ACE (Angiotensin Converting Enzyme) inhibitors have many complex actions. This includes lowering blood pressure and increasing the supply of blood and oxygen to the heart.  ACE inhibitors also help after a heart attack, as the heart muscle can be damaged and weakened.  They help by slowing down further weakening of the heart muscle (and make it easier for your heart to pump.  They reduce your risk of heart attack, stroke and kidney failure (in people with diabetes).

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How do I take them?

  • ACE inhibitors are usually taken once or twice a day, preferably at the same time each day. 
    It is important to keep taking these even if you feel well.
  • When you take the first dose, lie or sit down, as you might feel dizzy.  This may be due to a slight lowering of your blood pressure.  After the first dose on the first day of treatment, there is no need to take any special precautions.  A low dose is usually started at first, and slowly increased up to a standard dose over 2-4 weeks.

  • A blood test is usually done before starting an ACE inhibitor to check kidney function and the level of salts in the blood  This is repeated about 7-10 days after the first dose and at each dose increase until the desired dose is reached. 

  • Kidney function is checked as a small number of people can have reduced blood flow to the kidneys when ACE inhibitors are started.  Once your dose is stabilised you should have a blood test once a year to check your kidney function and the salts in your blood.

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Side effects

ACE inhibitors usually cause no problems but rarely some people can experience dizziness and a few people can get a dry cough. If this happens you should tell your doctor.   

ACE inhibitors can also increase the potassium level in the blood, so it's important not to take potassium supplements e.g. Slow K, Sando K (unless prescribed by your doctor). Also avoid salt substitutes eg. Lo-Salt (as this contains a lot of potassium)

Less common side effects include rashes and diarrhea.  Very rarely less than 1 in 10,000 people taking ACE inhibitors can be affected by a major allergic reaction with breathing difficulties or swelling of the face (including lips and tongue) if you are effected please seek urgent medical advice. 

If you think you have any side effects from this medicine be sure to mention them to your GP, practice nurse or pharmacist. 

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