Learning About ACE Inhibitors and ARBs for Diabetes

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ACE inhibitors and ARBs are medicines used to manage blood pressure. They allow blood vessels to relax and open up. This lowers your blood pressure.

When you have diabetes, taking an ACE inhibitor or ARB can help to:

  • Treat high blood pressure. Your risk of problems from diabetes goes up when you have high blood pressure.
  • Prevent or slow kidney damage. Diabetes can damage the blood vessels in the kidneys. High blood pressure can damage the kidneys, too.
  • Lower the risks of stroke and heart attack. Your risks go up when you have high blood pressure, heart disease, or both.

An ACE inhibitor or ARB is a good choice for people with diabetes. Unlike some medicines, these don't affect blood sugar levels.


ACE inhibitors include:

  • Benazepril.
  • Lisinopril.
  • Ramipril.

ARBs include:

  • Irbesartan.
  • Losartan.
  • Telmisartan.

Possible side effects

All medicines can cause side effects.

Some side effects of ACE inhibitors include:

  • Low blood pressure. You may feel dizzy and weak.
  • A dry cough.
  • High potassium levels.
  • Swelling of your lips, tongue, or face. If the swelling is severe, you may need treatment right away. Severe swelling can make it hard to breathe, but this is rare.

Some side effects of ARBs include:

  • Low blood pressure. You may feel dizzy and weak.
  • High potassium levels.

You may have other side effects or reactions not listed here. Check the information that comes with your medicine.

What to know about taking this medicine

  • Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Before starting an ACE inhibitor or ARB, tell your doctor if you:
    • Use a salt substitute.
    • Take diuretics or potassium tablets.
  • These medicines are not safe for pregnancy. If you are pregnant or planning to be, talk to your doctor about a safe blood pressure medicine.
  • ACE inhibitors can cause a dry cough. If the cough is bad, talk to your doctor. Switching to an ARB is likely to help.
  • Taking some medicines together can cause problems. Tell your doctor or pharmacist all the medicines you take. This includes over-the-counter medicines, vitamins, herbal products, and supplements.
  • You may need regular blood and urine tests.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.