ACE INHIBITORS-SIDE EFFECTS
- Hypotension: an initial sharp fall in BP occurs especially in diuretic-treated and CHF patients
- Hyperkalemia: more likely in patients with impaired renal function and in those taking K+ sparing diuretics, NSAIDs or beta blockers.
- Cough: a persistent brassy cough occurs in 4–16% patients within 1–8 weeks, often requires discontinuation of the drug—subsides 4–6 days thereafter. It is not dose-related and appears to be caused by inhibition of bradykinin/substance P breakdown in the lungs of susceptible individuals.
- Angioedema: resulting in swelling of lips, mouth, nose, larynx may develop within hours to few days in 0.06–0.5% patients; may cause airway obstruction.
- Dysgeusia: reversible loss or alteration of taste sensation.
- Foetopathic: foetal growth retardation, hypoplasia of organs and foetal death may occur if ACE inhibitors are given during later half of pregnancy. ACE inhibitors must be stopped when the woman conceives.
- Acute renal failure: is precipitated by ACE inhibitors in patients with bilateral renal artery stenosis due to dilatation of efferent arterioles and fall in glomerular filtration pressure. ACE inhibitors are contraindicated
in such patients.
Dry persistent cough is the most common side effect requiring discontinuation of ACE inhibitors.