side effects
Last reviewed 11/2023
Side effects of ACE inhibitors include:
- first-dose hypotension:
- increased risk in patients treated for heart failure, dehydration or on diuretics
- persistent dry cough:
- occurs in up to 20% of patients
- more frequent in women and non-smokers
- occurs in repetitive bouts, especially at night, and may precipitate vomiting and voice changes
- diagnosed by effect of stopping/reducing drug, CXR and peak flow diary to exclude other causes
- do not treat with antitussives; NSAID's may be beneficial
- withdraw ACEI if symptoms intolerable
- sore mouth, throat discomfort, loss of taste and voice changes
- abdominal pain
- rash
- angioedema
- hyperkaemia, proteinuria, thrombocytopenia, agranulocytosis, neutropenia - all more common in pre-existing renal impairment
- abnormal liver function test, cholestatic jaundice and liver damage
- renal impairment
- hypoglycaemia
cough associated with the use of ACE inhibitors
angioedema associated with ACE inhibitors
renal damage and ACE inhibitor use in renal artery stenosis
ACE inhibitors and raised creatinine in chronic kidney disease (CKD)