ACE-Hemmer
Begutachtet von Dr Colin Tidy, MRCGPZuletzt aktualisiert von Dr Toni Hazell, MRCGPZuletzt aktualisiert 18 Dec 2023
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ACE inhibitors are medicines that are used mainly in the treatment of high blood pressure (hypertension) and heart failure. They are also used in some people with diabetes, for some forms of kidney disease, and after a heart attack, to help protect the heart.
They have a variety of effects on the body. Their ability to relax blood vessels is one of the most important. The side-effects most commonly associated with ACE inhibitors are usually minor. A common side-effect is a persistent dry cough.
Auf einen Blick
ACE inhibitors are medicines used to treat high blood pressure, heart failure, and kidney conditions.
They work by relaxing blood vessels and reducing excess fluid in the body.
Common ACE inhibitors include ramipril, lisinopril, and enalapril.
Pregnant or breastfeeding women should not take ACE inhibitors.
Side-effects can include low blood pressure, dizziness, and a persistent dry cough.
Very rarely, they can cause swelling of the lips, eyes or tongue.
If you experience low blood pressure and dizziness, tell your doctor.

Unsicher beim Mischen von Medikamenten?
Überprüfen Sie mögliche Wechselwirkungen zwischen Medikamenten, Nahrungsergänzungsmitteln und Lebensmitteln, bevor Sie sie zusammen einnehmen.
What conditions are ACE inhibitors used to treat?
Angiotensin-converting enzyme (ACE) inhibitors are used to treat a number of different conditions:
Hoher Blutdruck (Hypertonie) - ACE inhibitors usually work well to lower blood pressure.
Herzinsuffizienz - ACE inhibitors reduce the strain on the heart by decreasing the amount of fluid pumped around the body. They also help the heart by relaxing blood vessels. This reduces the amount of force needed to eject blood from the heart.
Diabetische Nierenerkrankung (diabetic nephropathy) - these medicines can help to maintain good kidney function.
Chronische Nierenerkrankung - ACE inhibitors may help to slow the progress of kidney disease.
After a Herzinfarkt (Myokardinfarkt).
List of ACE inhibitors
Sie umfassen:
Each of these medicines also has various different brand names. Some ACE inhibitor medicines are also part of a combined tablet with a calcium-channel blocker medicine oder 'water tablet' (diuretic) medicine.
How do ACE inhibitors work?
ACE inhibitors prevent the body from creating a hormone known as angiotensin II. They do this by blocking (inhibiting) a chemical called angiotensin-converting enzyme.
Angiotensin II has three main effects:
Tightening (constriction) of blood vessels.
Re-absorption of water by the kidneys (taking water back into the body).
Release of the hormone aldosterone which also causes water re-absorption by the kidneys.
Increasing the volume of the blood by adding more water and constricting your blood vessels increases blood pressure.
ACE inhibitors reduce the amount of angiotensin II which causes blood vessels to dilate. The amount of water put back into the blood by the kidneys decreases. These actions reduce blood pressure.
In high blood pressure (hypertension), ACE inhibitors should help to reduce the blood pressure.
In heart failure, there may be too much circulating fluid in the blood vessels. ACE inhibitors help to reduce this. They appear to have a protective effect on the heart and slow the progression of the heart failure.
Who cannot take ACE inhibitors?
People who should not take ACE inhibitors include:
Schwangere und stillende Frauen.
Those with a known sensitivity to ACE inhibitors.
Those who have had a severe allergic response to ACE inhibitors in the past - eg, swelling of the lips, eyes or tongue (angio-oedema).
People with certain types of kidney disease - for example, renal artery stenosis.
A full list of people who should not take ACE inhibitors is included with the leaflet that comes with your medicine. If you are prescribed ACE inhibitors, read this to be sure you are safe to take it.
Side-effects of ACE inhibitors
Side-effects of ACE inhibitors can include:
Niedriger Blutdruck (hypotension).
Schwindel.
Persistent dry cough.
Swelling of the lips, eyes or tongue (angio-oedema).
Decline in kidney function.
If you experience low blood pressure and dizziness you should report it to your doctor.
Hinweis: the above is not the full list of side-effects for these medicines. Please see the leaflet that comes with your particular brand for a full list of possible side-effects and cautions.
A number of medicines may interact with ACE inhibitors. In particular, Nichtsteroidale entzündungshemmende Medikamente (NSAIDs), 'water tablets' (diuretics) and lithium. Your doctor will normally check what other medicines you take and give further advice about this.
So, make sure your doctor knows of any other medicines that you are taking, including ones that you have bought rather than been prescribed.

Unsicher beim Mischen von Medikamenten?
Überprüfen Sie mögliche Wechselwirkungen zwischen Medikamenten, Nahrungsergänzungsmitteln und Lebensmitteln, bevor Sie sie zusammen einnehmen.
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Häufig gestellte Fragen
Are there different strengths of ACE inhibitors?
The article mentions that each ACE inhibitor medicine also has various different brand names. It also states that some ACE inhibitor medicines are part of a combined tablet with other medications like calcium-channel blockers or diuretics. This suggests there can be different formulations or combinations, which may imply varying strengths or co-administered drugs, but it doesn't explicitly state 'strengths'.
Can ACE inhibitors be taken with other medications?
ACE inhibitors can interact with certain other medications. Specifically, non-steroidal anti-inflammatory drugs (NSAIDs), 'water tablets' (diuretics), and lithium are mentioned as interacting medicines. It is important to inform your doctor about all medicines you are taking, including those bought without a prescription, so they can provide appropriate advice.
What should I do if I experience a persistent dry cough while taking an ACE inhibitor?
A persistent dry cough is listed as a possible side-effect of ACE inhibitors. If you experience this or other side effects, the article recommends reporting low blood pressure and dizziness to your doctor. While it doesn't specifically mention the dry cough, it's generally good practice to discuss any bothersome side effects with your doctor.
What is angio-oedema and why is it important to know about it when taking ACE inhibitors?
Angio-oedema is a severe allergic response characterised by swelling of the lips, eyes, or tongue. It is a serious side-effect of ACE inhibitors. Individuals who have experienced angio-oedema in the past due to ACE inhibitors should not take them again. It’s important to be aware of this symptom as it can be serious.
Can I report a side-effect if it's not listed in the medicine leaflet?
Yes, you can report any suspected side-effect to a medicine, even if it's not listed in the leaflet, through the Yellow Card Scheme. This scheme helps medical professionals become aware of new or unreported side-effects. You can do this online at www.mhra.gov.uk/yellowcard, providing details about the side-effect, the medicine, the person affected, and your contact information.
Weiterführende Literatur und Referenzen
- Chronische Herzinsuffizienz bei Erwachsenen – Diagnose und Behandlung; NICE-Leitlinien (September 2018)
- Hypertonie bei Erwachsenen: Diagnose und Behandlung; NICE (August 2019 - zuletzt aktualisiert November 2023)
- Marx N, Federici M, Schutt K, et al; 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023 Oct 14;44(39):4043-4140. doi: 10.1093/eurheartj/ehad192.
Über den AutorVollständige Biografie anzeigen

Dr Toni Hazell, MRCGP
MBBS, BSc, MRCGP, DFSRH, Dip GU med, DRCOG, DCH (London, UK, 2000)
Dr. Toni Hazell hat ihren Abschluss an der St. Mary’s Hospital Medical School gemacht und ihr VTS am Northwick Park Hospital absolviert.
Über den RezensentenVollständige Biografie anzeigen

Dr Colin Tidy, MRCGP
Allgemeinmediziner, Medizinischer Autor
MBBS, MRCGP, MRCP (Paediatrics), DCH
Dr. Colin Tidy ist ein NHS-Arzt mit Sitz in Oxfordshire.
Artikelverlauf
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Next review due: 16 Dec 2028
18 Dec 2023 | Neueste Version

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