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Angiotensin-converting enzyme inhibitors, or more commonly known as ACE inhibitors, assist your body in lowering its blood pressure. These ACE inhibitors, such as lisinopril, captopril, and enalapril are antihypertensive medications and are often preferred to other options like beta-blockers. As with most medication, there are some side effects that people experience with ACE inhibitors, like an annoying, dry cough.

What ACE Inhibitors Are

When ACE inhibitors enter the body, they begin to block the angiotensin-converting enzyme, which works to convert angiotensin I and angiotensin II. As a result of this step, there is less angiotensin II, thus causing vasodilation (relaxing of blood vessels) and impairment of aldosterone activity, causing a decrease in blood pressure.

Aldosterone is a hormone produced by the adrenal glands and functions to regulate the filtration of urine by the kidney’s nephrons. This works by bringing in sodium and water into your circulation and excreeting potassium out of your urine. As a result of the impairment of aldosterone, the body retains more potassium and increases urine output decreasing the overall amount of fluid in the body (aiding in lowering blood pressure.) Some examples of ACE inhibitors include:

  • Lisinopril
  • Enalapril
  • Perindopril
  • Benazepril
  • Fosinopril
  • Captopril

ACE Inhibitors, Angioedema, and Cough

Angioedema (swelling commonly located below mouth, tongue, or extremities) can be a very serious side effect of taking an ACE inhibitor like lisinopril.

When one develops angioedema, the ACE inhibitor should be stopped immediately and steroids and diphenhydramine (Benadryl) can be given in order to calm the swelling. Swelling is considered a medical emergency in this case, because it can block your airway. Angioedema may occur at any time after starting an ACE inhibitor.

If you experience angioedema and life-threatening swelling while on an ACE inhibitor, stop taking your medication and call 911. Once treated with steroids and Benadryl, your physician will evaluate you and give you another drug for hypertension. 

A more common symptom of lisinopril and ACE inhibitors is a dry cough. This cough luckily requires no treatment other than the discontinuation of the drug. Since ACE inhibitors have a very short half-life, it usually takes no longer than a day to excrete the ACE inhibitor from your body. But, this symptom is still serious, so you should consult your physician for evaluation in order to discontinue the ACE inhibitor or start another medication. 

Other adverse reactions to ACE inhibitors include low blood pressure, hyperkalemia, medication interactions, or impaired kidney function. While taking ACE inhibitors, it’s crucial that you regularly monitor your blood pressure and keep in contact with your physician for best practice.

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