Examples: Ramipril and Candesartan
Indications:
Hypertension
Heart failure
Kidney disease
Stroke
Myocardial Infarction
Adverse Effects:
Dizziness
Dry Cough: most common drug-induced cough cause → switch to ARB instead which has less risk
Angioedema: swelling of face and lips, rare but unique
Hyperkalemia
Acute renal failure (if dehydrated)
Increased serum creatinine
Contraindicated in pregnancy
Drug Interactions:
Lithium: increased lithium levels by up to 50%
Medications that increase potassium levels (potassium supplements, potassium-sparing diuretics - spironolactone, sulfamethoxazole-trimethoprim): hyperkalemia
NSAIDs - increases blood pressure and kidney dysfunction
Do not combine Aliskiren (direct renin inhibitor), ACE inhibitor and ARB due to hypotension, angioedema and renal dysfunction