ACE Inhibitors


Drug class: Angiotensin-converting–enzyme (ACE) inhibitors

Generic (Brand) names: captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace)

In systolic heart failure, the heart muscle becomes thin and weak, causing part of the heart muscle to balloon outward. As a result, the heart can’t pump strongly enough to send sufficient oxygen- and nutrient-rich blood throughout the body.

ACE inhibitors can stop these changes in the heart muscle from getting worse.

ACE inhibitors do two things in heart failure. They block the hormone that can cause weakening and scarring in the heart and kidneys over time. They also help relax blood vessels by helping your body eliminate excess water and sodium; and lower blood pressure. This lowers the strain on your heart and allows it to pump more efficiently.

ACE inhibitors improve heart failure symptoms, reduce your chances of being hospitalized, and can help you live longer.

Side effects may include:

  • Dizziness, lightheadedness, fainting
  • Persistent dry cough
  • Angioedema, a rapid swelling in the face, neck, or tongue. This can be serious. Tell your provider immediately if it occurs.

Your provider will have told you what dose of this medication to take, and how many times per day to take it. The label on your medication bottle should also indicate how many pills to take, and how often.

Over time, your provider may adjust your dose.

Make sure the dose you need to take matches the strength of the tablets in your bottle. If the strength of your tablet does not match the dose you have been prescribed, you may need to split the pill and have only part of it, or take more than one pill. Always remember to consult your provider if you are unclear about what your most recent dose of ACE inhibitor is.

Take this medication on an empty stomach.

Tell your provider if you experience side effects. He or she may be able to switch you to a different drug class, switch you to a different drug within this class, or adjust your dose.

This medication causes your body to retain potassium. High blood levels of potassium can be dangerous. Notify your provider immediately if you experience any new or worsening weakness, fatigue, or palpitations.

You provider may ask you to monitor your blood pressure at home to make sure it is not too low.

You may also need blood tests to check your potassium levels and kidney function.

In the short term, you may not feel different if you do not take this medication as directed. Over time, however, you will feel worse and be at greater risk for hospitalization. Your heart failure will also continue to progress.