February 24, 2024

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ACEI antihypertensive drugs: 6 common side effects

ACEI antihypertensive drugs: 6 common side effects


ACEI antihypertensive drugs: 6 common side effects. 

There are 6 common side effects to ACEI antihypertensive drugs! During taking, please pay attention to these 4 points!

The full name of ACEI is angiotensin-converting enzyme inhibitor, which is a common type of antihypertensive drugs in clinical practice.

For example, captopril, enalapril, benazepril, etc. we often hear are all ACEI drugs .




ACEI antihypertensive drugs: 6 common side effects


1 What kind of antihypertensive drugs are ACEI drugs?

In clinical practice, we roughly divide ACEI (Prili) drugs into three generations:

  • The first generation is based on sulfhydryl as the main core group, and the representative drug is captopril;
  • The second generation is based on the carboxyl group as the core group, representing drugs such as enalapril, benazepril, perindopril, etc.;
  • The third generation is based on the phosphono group as the core group, which represents the drug Fusinopril.


The half-lives of these three generations of drugs are different. The half-life determines the number of doses per day.

For captopril with a half-life of only about 2 hours, it needs to be taken 2-3 times a day as a blood pressure drug; and for drugs with a half-life of more than 10 hours, it only needs to be taken once a day.


The metabolism of ACEI drugs is also different. Fosinopril and trandolapril are metabolized through the liver and kidney channels, which means that 50% of them are excreted in the feces through the liver and bile, and 50% Excreted through the kidneys.


Other ACEI drugs, such as captopril, benazepril, enalapril, etc., are mainly metabolized by the kidneys.


Regardless of whether it is the first generation of ACEI drugs, or the second and third generation of ACEI drugs, their mechanism of action is basically the same, except for the antihypertensive effect. Other effects are similar.


For patients with liver and kidney dysfunction, you can be slightly inclined to dual-channel metabolites of Pristine drugs.

For most other patients with normal liver and kidney function, which ACEI drug can be selected, it must be consulted by a doctor or pharmacist. Medication under the guidance.




2 What other diseases can ACEI drugs treat?

ACEI drugs play a hypotensive effect by blocking the activity of angiotensin II.

Many studies now prove that in addition to lowering blood pressure, it also has a clearer role in protecting the cardiovascular system, such as delaying the progression of heart failure, blocking or reversing ventricular remodeling.


In addition, for patients with diabetes and hypertension, it can also improve insulin resistance; in expert consensus, it is also recommended to choose ACEI drugs for stroke prevention.


It is precisely because of these effects of ACEI drugs that it is often used to treat high blood pressure with coronary heart disease, heart failure, heart failure or atrial fibrillation and other cardiovascular diseases, as well as diabetic nephropathy, metabolic syndrome and so on.




3. What are the possible adverse reactions during the administration of ACEI (Prili) antihypertensive drugs?

Dry cough

The most common adverse reaction of ACEI drugs is dry cough, because it can inhibit the degradation of kinin in the body and increase the level of bradykinin, which leads to dry cough.

This dry cough may be accompanied by itching, sometimes worse at night, and usually not accompanied by phlegm.


Gastrointestinal reaction

Taking ACEI drugs may cause mild gastrointestinal side effects, such as nausea, etc. However, such side effects may be tolerated after a while.


Increased blood potassium

ACEI drugs have the effect of inhibiting aldosterone, which can easily cause the increase of serum potassium.


Increased creatinine

ACEI drugs can reduce the glomerular filtration rate in the human body, which may cause an increase in creatinine.



The adverse reaction of angioedema is relatively rare, and its occurrence is related to the increase of bradykinin.



After taking ACEI drugs, some patients may also have adverse reactions of skin rash. Clinically, it needs to be differentiated from other allergic diseases.




4. What should I pay special attention to during the period of taking ACEI antihypertensive drugs?

Taboo people

To choose ACEI drugs, you need to first determine whether there are contraindications to these drugs, such as renal artery stenosis, hyperkalemia, pregnancy, etc.


Adverse reactions

After taking the drug, you need to pay attention to the adverse effects of the drug. Once it occurs, you should consult your doctor or pharmacist in time to see if you need to adjust the medication.


Drug interaction

When taking it with other drugs, pay attention to the interaction between drugs. For example, when combined with antipyretic analgesics, it may reduce the antihypertensive effect of the drug.


Adjust the dose

For the elderly or patients with liver and kidney dysfunction, the dosage should be adjusted according to the patient’s creatinine level and glomerular filtration rate.





ACEI antihypertensive drugs: 6 common side effects

(source:chinanet, reference only)

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