Angiotensin-converting enzyme (ACE) inhibitors

ACE inhibitors are commonly prescribed to treat high blood pressure, heart problems and other conditions. Find out how they work and their potential side effects.

By Mayo Clinic Staff

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

Examples of ACE inhibitors

Many ACE inhibitors are available. The best one for you depends on your health and other factors. 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

In addition to high blood pressure, ACE inhibitors prevent, treat or improve symptoms in conditions such as:

  • Coronary artery disease
  • Heart failure
  • Diabetes
  • Certain chronic kidney diseases
  • Heart attacks
  • Scleroderma — a disease that involves hardening of the skin and connective tissues
  • Migraines

Your doctor may prescribe other medications in addition to an ACE inhibitor, such as a diuretic or calcium channel blocker. ACE inhibitors shouldn't be taken with an angiotensin receptor blocker or with a direct renin inhibitor.

ACE inhibitors work better for younger people than for older people. They also work better for white people than for black people. Your doctor may recommend a different medication.

Side effects

Doctors commonly prescribe ACE inhibitors because they don't often cause side effects.

If side effects do occur, they may include:

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

In rare cases, particularly for black people, women and smokers, 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 your ACE inhibitor works, but talk to your doctor if you regularly take NSAIDs.

ACE inhibitors can be harmful to you and your baby during pregnancy. If you're pregnant or plan to become pregnant, talk to your doctor about other options to treat high blood pressure.

Aug. 20, 2019 See more In-depth