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PEBC: What You Need to Know: ACE Inhibitors (-pril) and ARBs (-tan)

Updated: Jul 25, 2020

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

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