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- What are ACE inhibitors, and how do they work (mechanism of action)?
- Why are ACE inhibitors prescribed (uses)?
- What are the side effects and adverse event of ACE inhibitors?
- List of examples of brand and generic drug names for ACE inhibitors
- Are there any differences among the different types of ACE inhibitors?
- What drugs or supplements interact with ACE inhibitor drug class?
What are ACE inhibitors, and how do they work (mechanism of action)?
Angiotensin II is a very potent chemical produced by the body that primarily circulates in the blood. It causes the muscles surrounding blood vessels to contract, thereby narrowing the vessels. The narrowing of the vessels increases the pressure within the vessels causing increases in blood pressure (hypertension). Angiotensin II is formed from angiotensin I in the blood by the enzyme angiotensin converting enzyme (ACE). (Angiotensin I in the blood is itself formed from angiotensinogen, a protein produced by the liver and released into the blood.) Angiotensin converting enzyme inhibitors (ACE inhibitors) are medications that slow (inhibit) the activity of the enzyme ACE, which decreases the production of angiotensin II. As a result, blood vessels enlarge or dilate, and blood pressure is reduced. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.
Why are ACE inhibitors prescribed (uses)?
- ACE inhibitors are used for:
- ACE inhibitors also improve survival after heart attacks. In studies, individuals with hypertension, heart failure, or prior heart attacks who were treated with an ACE inhibitor lived longer than patients who did not take an ACE inhibitor.
- ACE inhibitors are an important group of drugs because they prevent early death resulting from hypertension, heart failure or heart attacks.
- Some individuals with hypertension do not respond sufficiently to ACE inhibitors alone. In these cases, other drugs often are used in combination with ACE inhibitors.
What are the side effects and adverse event of ACE inhibitors?
ACE inhibitors are well-tolerated by most individuals. Nevertheless, they are not free of side effects, and some patients should not use ACE inhibitors. ACE inhibitors usually are not prescribed for pregnant women because they may cause birth defects. Individuals with bilateral renal artery stenosis (narrowing of the arteries that supply the kidneys) may experience worsening of kidney function, and people who have had a severe reaction to ACE inhibitors probably should avoid them.
The most common side effects are:
- Elevated blood potassium levels
- Low blood pressure,
- Abnormal taste (metallic or salty taste)
- Chest pain
- Increased uric acid levels
- Sun sensitivity
- Increased BUN and creatinine levels
The most serious, but rare, side effects of ACE inhibitors are:
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List of examples of brand and generic drug names for ACE inhibitors
The following is a list of the ACE inhibitors that are available in the United States:
- benazepril (Lotensin)
- captopril (Capoten- discontinued brand)
- enalapril (Vasotec, Epaned, [Lexxel- discontinued brand])
- fosinopril (Monopril- Discontinued brand)
- lisinopril (Prinivil, Zestril, Qbrelis)
- moexipril (Univasc- Discontinued brand)
- perindopril (Aceon)
- quinapril (Accupril)
- ramipril (Altace)
- trandolapril (Mavik)
Are there any differences among the different types of ACE inhibitors?
ACE inhibitors are very similar. However, they differ in how they are eliminated from the body and their doses. Some ACE inhibitors remain in the body longer than others, and are given once a day. Some ACE inhibitors need to be converted into an active form in the body before they work. In addition, some ACE inhibitors may work more on ACE that is found in tissues than on ACE that is present in the blood. The importance of this difference or whether one ACE inhibitor is better than another has not been determined.
What drugs or supplements interact with ACE inhibitor drug class?
ACE inhibitors have few interactions with other drugs.
- Since ACE inhibitors may increase blood levels of potassium, the use of potassium supplements, salt substitutes (which often contain potassium), or other drugs that increase the body's potassium may result in excessive blood potassium levels.
- ACE inhibitors also may increase the blood concentration of lithium (Eskalith, Lithobid) and lead to an increase in side effects from lithium.
- There have been reports that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever etc.), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the blood pressure lowering effects of ACE inhibitors.
- Patients receiving diuretics may experience excessive reduction in blood pressure when ACE inhibitors are started. Stopping the diuretic or increasing salt intake prior to taking the ACE inhibitor may prevent excessive blood pressure reduction. Close supervision for at least two hours after the start of ACE inhibitors and until blood pressure is stable is recommended if the diuretic cannot be stopped.
- ACE inhibitors should not be combined with ARBs because such combinations increase the risk of hypotension, hyperkalemia, and renal impairment.
- Ace inhibitors should not be combined with aliskiren (Tekturna), another class of drugs that is used to treat high blood pressure because such combinations increase the risk of kidney failure, excessive low blood pressure, and hyperkalemia.
- Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure) may occur when injectable (gold sodium aurothiomalate [Myochrysine]), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors.
ACE inhibitors, or angiotensin (generic name) converting enzyme
inhibitors, is a class of drugs that interact with blood enzymes to enlarge or
dilate blood vessels and reduce blood pressure. These drugs are used to control
high blood pressure (hypertension), treat heart problems, kidney disease in
people with diabetes high blood pressure. These
drugs also improve the survival rate of people who have survived heart attacks
and they prevent early death of people from heart attacks, high blood pressure,
and heart failure. Sometimes ACE inhibitors are combined with other drugs for
treating a condition.
Examples of ACE inhibitors include benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), and ramipril (Altace). Examples of the most common side effects of this class of drugs are dizziness, headache, cough, rash, chest pain, and rash. There are serious side effects of this drug like kidney failure, severe allergic reactions, and liver dysfunction, or failure. ACE inhibitors all are similar in the way they work; however, they differ in how the body eliminates doses of the drug. Drug interactions, dosage, and pregnancy and safety information should be reviewed prior to taking this medication.
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Kidney Pain Symptoms, Treatment, and Cure
Kidney pain has a variety of causes and symptoms. Infection, injury, trauma, bleeding disorders, kidney stones, and less common conditions may lead to kidney pain. Symptoms associated with kidney pain may include fever, vomiting, nausea, flank pain, and painful urination. Treatment of kidney pain depends on the cause of the pain.
Congestive Heart Failure (CHF) Symptoms, Treatment, and Life Expectancy
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Heart Attack Symptoms and Early Warning Signs
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Hypertension-Related Kidney Disease
Second Source WebMD Medical Reference
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Heart Attack Treatment
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Heart Disease in Women
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Diabetes and Kidney Disease
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Heart Attacks in Women
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Heart Attack Pathology: Photo Essay
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Kidney Dysplasia: In Infants and Children
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Heart Attack Prevention
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Heart Disease Treatment in Women
Heart disease treatment in women should take into account female-specific guidelines that were developed by the American Heart Association. Risk factors and symptoms of heart disease in women differ from those in men. Treatment may include lifestyle modification (diet, exercise, weight management, smoking cessation, stress reduction), medications, percutaneous intervention procedure (PCI), and coronary artery bypass grafting (CABG). Heart disease is reversible with treatment.
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Heart Attack Prevention Overview
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack also is a significant cause of heart failure. The process of developing atherosclerosis (hardening of the arteries) begins early in life. Heart attack prevention should begin in childhood because the atherosclerosis process can not be reversed. The risk of having a heart attack increases if you have diseases or conditions such as high blood pressure, diabetes, and other heart conditions. You can lowering your risk of having a heart attack by: Lifestyle changes, for example: Diet Exercise Quit smoking Control high blood pressure, diabetes, and other diseases that are risk factors) In some cases, medication is the most effective way of preventing a heart attack
Treatment & Diagnosis
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Medications & Supplements
- High Blood Pressure Drugs (Hypertension)
- Vasodilators (Drug Class Side Effects, List of Names)
- lisinopril (Zestril, Prinivil, Qbrelis) ACE Inhibitor
- Calcium Channel Blockers (CCBs)
- Congestive Heart Failure Medications
- hydralazine (Apresoline)
- Drug Interactions
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- ramipril (Altace)
- captopril (Capoten)
- benazepril (Lotensin HTC)
- enalapril (Vasotec, Epaned)
- quinapril (Accupril)
- perindopril - oral, Aceon
- fosinopril sodium, Monopril
- lisinopril and hydrochlorothiazide (Zestoretic, Prinzide)
- trandolapril (Mavik)
- captopril and hydrochlorothiazide (Capozide)
- enalapril and hydrochlorothiazide (Vaseretic)
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