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Angiotensin-Converting Enzyme (ACE) Inhibitors for Heart Attack and Unstable Angina

Examples

Generic Name Brand Name
benazepril Lotensin
captopril Capoten
enalapril Vasotec
fosinopril  
lisinopril Prinivil, Zestril
perindopril Aceon
quinapril Accupril
ramipril Altace
trandolapril Mavik

How It Works

Angiotensin-converting enzyme (ACE) inhibitors interfere with the formation of a hormone (angiotensin II) that can narrow (constrict) blood vessels. ACE inhibitors help lower blood pressure and reduce the workload on the heart.

Why It Is Used

ACE inhibitors are recommended immediately after a heart attack to help people live longer. These drugs frequently are used to treat high blood pressure and heart failure.

How Well It Works

If used within 24 hours of the start of heart attack symptoms, ACE inhibitors reduce the risk of future death associated with a heart attack.1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Irregular heartbeats (this could be caused by too much potassium in your blood).
  • Dizziness or lightheadedness or fainting.

Common side effects of this medicine include:

  • Dry cough.
  • Headache.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

ACE inhibitor cough

A cough is one of the most common side effects of ACE inhibitors. But most people do not get a cough. The cough tends to be a minor problem for most people who have it. They feel that they can live with it in exchange for the benefits of this medicine.

If you take an ACE inhibitor and have a problem with coughing, talk with your doctor. Your cough may be caused by something else, like a cold. Do not stop taking your medicine unless your doctor tells you to.

If you have a cough that is a problem for you, then your doctor might give you an angiotensin II receptor blocker (ARB) instead. ARBs are less likely to cause a cough.

Interactions with other medicines

ACE inhibitors may interact with other medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs), antacids, potassium supplements, certain diuretics, and lithium. If you are taking one of these medicines, talk with your doctor before you take an ACE inhibitor.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.

Checkups

To make sure this medicine is not causing problems, your doctor may check what your potassium levels are and how your kidneys are working.

You will likely have regular blood tests to monitor how the medicine is working in your body and to see if this medicine is causing problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Hass EE, et al. (2011). ST-segmented elevation myocardial infarction. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 2, pp. 1354–1385. New York: McGraw-Hill.

Credits

By Healthwise Staff
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
Last Revised July 17, 2013

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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Angiotensin-Converting Enzyme (ACE) Inhibitors for Heart Attack and Unstable Angina