ACE Inhibitors (cont.)

Are there any differences among the different types of ACE inhibitors?

ACE inhibitors are very similar, and all are effective for treating hypertension. Some are eliminated primarily by the kidneys while others are also eliminated in bile and feces. This difference in elimination may be important in choosing among ACE inhibitors in patients with reduced kidney or liver function, who may accumulate drugs that are excreted via the kidneys or liver. Except for captopril (Capoten) and lisinopril (Prinivil, Zestril), ACE inhibitors are inactive until they are converted to an active form in the body.

What are the side effects of ACE inhibitors?

Common side effects are:

• dizziness,
• headache,
• drowsiness,
• diarrhea,
• low blood pressure,
• weakness,
• cough, and
• rash.

An abnormal taste (metallic or salty), elevated blood potassium levels, and sexual dysfunction may also occur.

A nonproductive and persistent cough may occur in 5%-25% of individuals. It may take up to 2 weeks or longer for coughing to subside after the ACE inhibitor is discontinued. If one ACE inhibitor causes cough, it is likely that the others will also.

ACE inhibitors may cause birth defects and, therefore, should not be used during pregnancy.

Individuals with stenosis (narrowing) of both arteries supplying the kidneys may experience worsening of kidney function.

Other side effects of ACE inhibitors include kidney failure, allergic reactions, a decrease in white blood cells, and swelling of tissues (angioedema).