Side effects
Side effects of ACE inhibitors include:
- first-dose hypotension:
- increased risk in patients treated for heart failure, dehydration or on diuretics
- persistent dry cough:
- occurs in up to 20% of patients
- more frequent in women and non-smokers
- occurs in repetitive bouts, especially at night, and may precipitate vomiting and voice changes
- diagnosed by effect of stopping/reducing drug, CXR and peak flow diary to exclude other causes
- do not treat with antitussives; NSAID's may be beneficial
- withdraw ACEI if symptoms intolerable
- sore mouth, throat discomfort, loss of taste and voice changes
- abdominal pain
- rash
- angioedema
- hyperkaemia, proteinuria, thrombocytopenia, agranulocytosis, neutropenia - all more common in pre-existing renal impairment
- abnormal liver function test, cholestatic jaundice and liver damage
- renal impairment
- hypoglycaemia
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