Ever been prescribed lisinopril or ramipril and wondered what they actually do? ACE inhibitors are a common class of blood pressure and heart medicines. They block the angiotensin-converting enzyme (ACE), which lowers angiotensin II levels. That relaxes blood vessels, cuts blood pressure, and eases the workload on your heart.
Doctors use ACE inhibitors for high blood pressure, heart failure, after a heart attack, and to slow kidney damage in people with diabetes. Common drugs in this group are lisinopril, enalapril, ramipril, captopril and benazepril. They often become a first choice because they protect the heart and kidneys, not just lower blood pressure.
Typical starting doses vary: lisinopril often starts at 5–10 mg once daily (titrated up to 40 mg), ramipril 2.5–5 mg daily, and enalapril 2.5–5 mg twice daily. Your doctor will pick the right dose based on age, other conditions, and current medications.
The most common side effect is a dry, persistent cough. If that starts, tell your doctor—switching to an ARB often fixes it. Other important issues are low blood pressure (you may feel dizzy), high potassium (hyperkalemia), and a small but serious risk of angioedema—swelling of the face, lips, tongue, or throat. If swelling or breathing trouble happens, seek emergency care right away.
Before you start an ACE inhibitor, your provider should check kidney function and potassium. Repeat tests are usually done 1–2 weeks after starting or after dose increases. If your creatinine rises a lot or potassium climbs, your doctor may reduce the dose or stop the drug.
Avoid taking NSAIDs (like ibuprofen) regularly with ACE inhibitors—combining them can harm the kidneys and reduce blood pressure control. Also be cautious with potassium supplements, potassium-sparing diuretics (spironolactone), and lithium—these increase the risk of high potassium or lithium toxicity.
Never take an ACE inhibitor during pregnancy. These drugs can cause serious birth defects and should be stopped before trying to conceive. If you are pregnant or planning pregnancy, tell your prescriber immediately.
Simple tips: start low, move slowly with dose changes, and report symptoms such as dizziness, a new cough, or facial swelling. Fill prescriptions from a trusted pharmacy and keep regular follow-up blood tests. If you have questions about a specific ACE inhibitor, dose, or interaction with other meds, contact your healthcare provider—small changes in treatment can make a big difference in safety and results.
Need more reading? Browse our related posts or use the contact page to ask specific questions about ACE inhibitors and your health plan.
