Angiotensin-converting enzyme (ACE) inhibitors

These drugs are commonly prescribed to treat high blood pressure, heart problems and more.

By Mayo Clinic Staff

Angiotensin-converting enzyme (ACE) inhibitors are medications that help relax the veins and arteries to lower blood pressure. ACE inhibitors prevent an enzyme in the body from producing angiotensin II, a substance that narrows blood vessels. This narrowing can cause high blood pressure and forces the heart to work harder. Angiotensin II also releases hormones that raise blood pressure.

Examples of ACE inhibitors

Many ACE inhibitors are available. The best one for you depends on many things, including your overall health and existing conditions. For example, people with chronic kidney disease may benefit from having an ACE inhibitor as one of their medications.

Examples of ACE inhibitors include:

  • Benazepril (Lotensin)
  • Captopril
  • Enalapril (Vasotec)
  • Fosinopril
  • Lisinopril (Prinivil, Zestril)
  • Moexipril
  • Perindopril
  • Quinapril (Accupril)
  • Ramipril (Altace)
  • Trandolapril

When ACE inhibitors are used

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

  • High blood pressure (hypertension)
  • Coronary artery disease
  • Heart failure
  • Diabetes
  • Certain chronic kidney diseases
  • Heart attacks
  • A disease that involves hardening of the skin and connective tissues (scleroderma)
  • Migraines

Sometimes, another blood pressure medication — such as a diuretic or calcium channel blocker — is prescribed with an ACE inhibitor. ACE inhibitors shouldn't be taken with an angiotensin receptor blocker or with a direct renin inhibitor.

Side effects

Side effects of ACE inhibitors may include:

  • Dry cough
  • Increased potassium levels in the blood (hyperkalemia)
  • Fatigue
  • Dizziness from blood pressure going too low
  • Headaches
  • Loss of taste

Rarely, ACE inhibitors can cause some areas of the tissues to swell (angioedema). If swelling occurs in the throat, it can be life-threatening.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), decrease the effectiveness of ACE inhibitors. Taking an occasional dose of these medications shouldn't affect how an ACE inhibitor works, but talk to your doctor if you regularly take NSAIDs.

Taking ACE inhibitors during pregnancy increases the risk of birth defects in the baby. If you're pregnant or plan to become pregnant, talk to your doctor about other options to treat high blood pressure.

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Sept. 08, 2021 See more In-depth

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