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Heart failure medicine: ACE (angiotensin converting enzyme) inhibitors

ACE (angiotensin converting enzyme) inhibitors are medicines that relax blood vessels and make it easier for your heart to pump blood. They may help you feel better, have fewer symptoms and live longer.

With heart failure, your body makes too many stress hormones. Over time these hormones can be harmful to your heart. ACE inhibitors block the effects of the hormones and protect your heart.

They may also be used for people who have high blood pressure or who have had heart attacks, but they will help you even if you don't have these problems.

You may have to wait several weeks of taking ACE inhibitors before you notice any changes.

Frequently used ACE inhibitors include:

  • enalapril (Vasotec®)
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    Enalapril

    Treats high blood pressure (hypertension) and heart failure.

    Learn more about enalapril here.

  • captopril (Capoten®)
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    Captopril

    Treats high blood pressure (hypertension) and heart failure.

    Learn more about captopril here.

  • lisinopril (Zestril® and Prinivil®)
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    Lisinopril

    Treats high blood pressure (hypertension) and heart failure. Also used in the first few days after a heart attack. Helps to reduce the risk of death by making the heart more stable after the attack.

    Learn more about lisinopril here.

  • quinipril (Accupril®).

Side effects

Most people have few side effects from ACE inhibitors. The possible side effects include:

Important

If you have any of the side effects listed here, call your health care provider as soon as possible.

  • dizziness (especially in the morning). This may be slight if your ACE inhibitor is started at a low dose and gradually increased. Get slowly out of bed or a chair. Call your health care provider if the dizziness lasts longer than 10 minutes in the morning or if you are so dizzy you have trouble walking.
  • dry cough that won't go away. This cough is common with ACE inhibitors. It may decrease once you have been taking the medicine for a while. If the cough is from the medicine, not from the heart failure, your health care provider may decrease the dose or switch your medicine.
  • increased swelling (especially in your lips or throat). This side effect is rare but it is serious. Call your health care provider if you have swelling.
  • joint or muscle pain. This is arthritis-like pain that may occur in the legs, hips, knees, shoulders, back or neck.
  • problems with your kidneys or potassium level. You will have blood tests done occasionally to watch for any problems.
  • low blood pressure. Ask your health care provider how often you should have your blood pressure checked.

When to call your health care provider

Some side effects may go away as your body adjusts to the ACE inhibitor. But, if any of the following side effects won't go away or bother you, call your doctor or nurse:

  • diarrhea
  • headache
  • loss of taste or unusual taste in your mouth
  • nausea
  • unusual tiredness.

ACE inhibitors may increase the amount of potassium in your body. Signs of too much potassium include:

Important

If you have any of the signs of too much potassium listed here call your health care provider.

  • confusion
  • slow, weak pulse
  • nervousness
  • numbness or tingling in your hands, feet or lips
  • weakness or a heavy feeling in your legs
  • nausea or vomiting.

 

 

Source: Allina Health's Patient Education Department, Heart Failure, third edition, ISBN 1-931876-20-7

First published: 10/04/2002
Last updated: 07/19/2008

Reviewed by: Allina Health's Patient Education Department experts