Angiotensin-converting enzymes (ACE) inhibitors help blood vessels to relax and open. This can help improve blood flow and lower blood pressure.

Doctors typically prescribe ACE inhibitors for heart-related conditions like high blood pressure and heart failure. But these medications can also help to treat other diseases like diabetes and chronic kidney disease.

Antihypertensives are medications that lower blood pressure and come in a variety of classes. ACE inhibitors are one class of antihypertensives.

Doctors regularly prescribe ACE inhibitors to treat hypertension. Hypertension, commonly known as high blood pressure, is a severe condition that affects 1 in 3 adults in the United States.

ACE inhibitors can also help to treat other conditions like:

You’ll typically take an ACE inhibitor just once a day, often in the morning. Doctors may prescribe them along with diuretics or calcium channel blockers, which also help treat high blood pressure.

There are many different medications under the ACE inhibitor classification. The main difference between the types is their duration. Some types of ACE inhibitors are more effective in the short term, while others are more common for long-term treatments.

Common ACE inhibitors include:

On April 22, 2022, Pfizer issued a voluntary recall of 5 lots of the drug Accupril due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the Acceptable Daily Intake (ADI) as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all Accupril tablets made by Pfizer. If you take Accupril tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall.

Most ACE inhibitors are oral medications. The exception is enalapril, which doctors will administer intravenously.

Learn more about intravenous medication here.

ACE inhibitors have two primary functions. First, they stop the production of a hormone called angiotensin II. This hormone causes your blood vessels to narrow, reducing flow. As levels of this hormone drop due to ACE inhibitors, your vessels will relax and open up, increasing blood flow around the body.

Secondly, ACE inhibitors decrease the amount of sodium retained in the kidneys.

The combination of these factors can help treat a range of blood-related conditions, not just hypertension.

Some over-the-counter pain medications may decrease the effectiveness of ACE inhibitors. Make sure to check with your doctor before taking ibuprofen (Advil), naproxen (Aleve), and other nonsteroidal anti-inflammatory drugs (NSAIDs).

Taking these pain medications occasionally while taking a prescribed ACE inhibitor may not be immediately harmful. But you should avoid using them regularly. Speak with your doctor or pharmacist if you have any concerns about potential drug interactions.

ACE inhibitors are also not as effective in treating chronic kidney disease in people who smoke. As the exact reason for this is currently not clear, people who smoke should speak with their doctor about their risks before using an ACE inhibitor.

Your diet can also interact with medications. Eating a diet high in salt can reduce the effectiveness of ACE inhibitors in lowering blood pressure.

If a person’s blood-potassium levels increase due to ACE inhibitor use, doctors may need to lower their dosage. Patients can help prevent this from occurring by reducing the amount of potassium they eat in their diet.

Most people tolerate these medications well. But like all medications, ACE inhibitors can cause several side effects, including:

Due to the possible side effects of ACE inhibitors, you should always follow medical advice regarding taking them. If your doctor prescribes your ACE inhibitors, you should only take the amount they recommend. In some instances, they may not prescribe these medications at all.

Can pregnant people take them?

Due to the risk of side effects, doctors typically do not prescribe ACE inhibitors to pregnant people.

Studies show that exposure to ACE inhibitors during pregnancy can disturb embryo and fetus development and increase the risk of adverse health outcomes in pregnant persons.

Doctors can prescribe alternatives to ACE inhibitors for those planning a pregnancy. Some medical professionals advise that people of childbearing age avoid the use of ACE inhibitors altogether.

Can children take them?

Many types of ACE inhibitors have FDA approval to treat hypertension in children over the age of 6.

As with all medications, caregivers should ensure that children take ACE inhibitors as medical professionals direct.

As with any prescribed medication, you should never stop taking an ACE inhibitor unless instructed by your doctor. It may be tempting to stop taking the medication once you’re feeling better. But consistently taking prescribed medication will help keep your blood pressure in a healthy range.

If you’re experiencing side effects, call your doctor before you stop taking the medication. Your side effects may diminish over time. Your doctor may also have special instructions on how to discontinue the medication.

ACE inhibitors can be an important tool in maintaining normal blood pressure and a healthy heart. The key is taking your medication as prescribed and being mindful of potential interactions.