Side Effects of ACE Inhibitors:
- Low blood pressure is the main side effect of ACE inhibitors. This can be severe in some patients, especially at the start of therapy.
- Irritating cough is a common side effect, which some people find intolerable. Although all ACE inhibitors can have this side effect, sometimes switching to another brand will reduce this symptom.
- Although ACE inhibitors can protect against kidney disease, they also increase potassium retention in the kidneys. This increases the risk for cardiac arrest if potassium levels become too high. Because of this action, they are not generally given with potassium-sparing diuretics or potassium supplements.
- A rare but severe side effect is granulocytopenia, which is an extreme reduction in infection-fighting white blood cells.
- In very rare cases, patients suffer a sudden and severe allergic reaction called angioedema that causes swelling in the eyes and mouth and may close off the throat.
Patients who have difficulty tolerating ACE inhibitor side effects are usually switched to an angiotensin-receptor blocker (ARB).
Angiotensin-Receptor Blockers (ARBs)
ARBs, also known as angiotensin II receptor antagonists, are similar to ACE inhibitors in their ability to open blood vessels and lower blood pressure. They may have fewer or less-severe side effects than ACE inhibitors, especially coughing, and are sometimes prescribed as an alternative to ACE inhibitors. Some patients with heart failure take an ACE inhibitor along with an ARB.
Brands and Indications. ARBs are used to treat Stage A high-risk conditions such as high blood pressure and diabetic nerve disorders (neuropathy). They are also used to treat Stage B patients who have had a heart attack or who have left ventricular systolic disorder, and Stage C patients with heart failure. Specific brands, and the stage of heart failure they are used for, are listed below.
- Candesartan (Atacand) – (Stages A, C)
- Eprosartan (Teveten) – (Stage A)
- Irbesartan (Avapro) – (Stage A)
- Losartan (Cozaar) – (Stages A, B)
- Olmesartan (Benicar) – (Stage A)
- Telmisartan (Micardis) – (Stage A)
- Valsartan (Diovan) – (Stages A, B, C)
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