Angiotensin-converting enzyme (ACE) inhibitors

By Mayo Clinic Staff

Angiotensin-converting enzyme inhibitors, also called ACE inhibitors, are medicines that lower blood pressure. ACE inhibitors prevent an enzyme in the body from making angiotensin 2, which makes blood vessels narrow. The heart has to work harder when blood vessels are narrowed. That can make blood pressure go up. Angiotensin 2 also releases hormones that raise blood pressure.

There are many types of ACE inhibitors. The best one for you depends on many things, including your overall health. For example, an ACE inhibitor may help if you have chronic kidney disease.

Examples of ACE inhibitors include:

• Benazepril (Lotensin).
• Captopril.
• Enalapril (Epaned, Vasotec).
• Fosinopril.
• Lisinopril (Qbrelis, Zestril).
• Moexipril.
• Perindopril.
• Quinapril.
• Ramipril (Altace).
• Trandolapril.

ACE inhibitors are used to prevent, treat, or improve symptoms in conditions such as:

• High blood pressure, also called hypertension.
• Coronary artery disease.
• Heart failure.
• Diabetes.
• Some types of chronic kidney disease.
• Heart attacks.
• Scleroderma, a disease that involves hardening of the skin and connective tissues.
• Migraines.

An ACE inhibitor sometimes is used with another blood pressure medicine, such as a diuretic or calcium channel blocker.

Do not take ACE inhibitors with any of the following medicines:

• Angiotensin receptor blockers, also called ARBs.
• Angiotensin receptor neprilysin inhibitors.
• Direct renin inhibitors.

Do not take an ACE inhibitor if you are pregnant. The medicines have been linked to birth defects in babies. If you’re pregnant or plan to become pregnant, ask your healthcare professional about other options to treat high blood pressure.

Nonsteroidal anti-inflammatory drugs, also called NSAIDs, decrease how well ACE inhibitors work. Examples of NSAIDs are ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).

Possible side effects of ACE inhibitors are:

• Dry cough.
• Too much potassium in the blood.
• Extreme tiredness or dizziness from blood pressure going too low.
• Headaches.
• Loss of taste.
• Rarely, short-term worsening of kidney function.

Rarely, ACE inhibitors can cause swelling under the skin. If swelling happens in the throat, it can be life-threatening.

If you have any questions about the medicines you take, talk with your healthcare professional.