ACE inhibitors include- Benazepril, Captopril, Enalapril, Enalaprilat, Fosinopril, Lisonopril, Moexipril, Perindopril, Quinapril, Ramipril, Trandolapril

Refer Captopril 

Drug Interactions - summary

+ ACE inhibitors

Potassium salts-                                                                                                      concurrent use result in elevated serum potsssium concentrations in certain patients 

Concomittant administration of diuretics may lead to serious hypotension. With potassium-sparing diuretics dangerous hypokalaemia may result.

May increase serum lithium concentration.

NSAIDs may reduce the effect of the drug and cause deterioation of renal function.

Reduction in BP may affect, ability to drive and operate machinery. This is exacerbated by alcohol. Inhibits tachycardia mediated by vasodilators (hydrlazine,minoxdil).

ACE inhibitors include- Benazepril, Captopril, Enalapril, Enalaprilat, Fosinopril, Lisonopril, Moexipril, Perindopril, Quinapril, Ramipril, Trandolapril Refer Captopril 

Indications:

Hypertension alone or in combination with diuretics. Heart Failure 

Hypersens,history of angioedema with ACE inhibitors,bilateral artery stenosis, or a single kidney with uniateral renal artery stenosis.

Pregnancy,lactation. Special precautions: Stop medicaction when pregnacy is detected.

Approved by FDA in 1991

Hypertension alone or in combination with diuretics.

Dosage: Initial 2.5mg once daily Adjust dose according to response.

Maintenance- 2.5 to 20mg/day as single or divided doses.

Missed dose-

1. If you miss a dose of this medicine, and remember within 6 hours of take it as soon as possible unless the dose is less than 4 hours.

2. However, if you do not remember until later, skip the missed dose and go back to your regular dosing schedule.

3. Do not double doses.

1. Take captopril 1 hour before meals. Take moexipril in the fasting state

2. Do not interupt or discontinue medication without consulting physician

3. Notify physician if any of the following occur- sore throat, fever, swelling of hands or feet, irregular heart beat , chest pains, signs of angioedema, excessive prespiration, dehydration, vomiting and diarrhea may lead to a fall in blood pressure.

4. May cause dizziness, fainting or lightheadedness, especially during the first days of therapy; avoid sudden changes in posture. If syncope occurs, discontinue drug until physician has been contacted. Heart failure patients should avoid rapid increases in physical activity.

5. May cause skin rash or impaired taste perception. Notify physician if these persist.

6. Do not use salt substitutes containing potassium without consulting a physician

7. A persistent dry cough may occur and usually does not subside unless the medication is stopped. If this effect become bothersome, consult a physician.

Pharmacology:

The angiotensin converting enzyme inhibitors (ACEIs) appear to act primarily through suppression of the renin-angiotensin-aldosterone system, however no consistent correlation has been described between the renin levels and the drug response. Inhibiting ACE results in decreased plasma angiotensin II and increased plasma renin activity, the latter resulting from loss of negative feedback on renin release caused by reduction in angiotensin II. The ACEIs produce a reduction of peripheral arterial resistence in hypertensive patients, and either as no change or an increase in cardiac output.

ACE inhibitors-

Captopril, enalapril, lisonopril, quinopril, moexipril, ramipril, fosinopril, benzapril Food significantly reduces the bioavailability of captopril by 30 to 40%. Administer captopril 1 hour after meals. Food intake reduces absorption of moexipril.

Take moexipril in the fasting state The rate and extent of quinapril are diminished moderately when administered during a high fat meal.

The rate but not extent of ramipril and fosinopril absorption is reduced by food. Food does not reduce the GI absorption of benzapril, enalapril and lisonopril

ACE inhibitors-

Captopril, enalapril, lisonopril, quinapril, moexipril,ramipril, fosinopril, benzapril

Pregnancy: ACEIs can cause fetal and neonatal morbidity and death when administered to pregnant women when pregnancy is detected, discontinue ACEIs as soon as possible.

Lactation: Excercise caution when these drugs are administered to nursing women.

Children: Safety and efficacy have not been established.