Learning About ACE Inhibitors and ARBs for Diabetes

Introduction

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are medicines used to manage blood pressure. They allow blood vessels to relax and open up. This lowers your blood pressure.

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

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.

Examples

For each medicine in the list, the generic name is first. This is followed by any brand names.

These are some angiotensin-converting enzyme (ACE) inhibitors.

• Benazepril (Lotensin)
• Enalapril (Vasotec)
• Lisinopril (Prinivil, Zestril)
• Ramipril (Altace)

These are some angiotensin II receptor blockers (ARBs).

• Candesartan (Atacand)
• Irbesartan (Avapro)
• Losartan (Cozaar)
• Olmesartan (Benicar)
• Valsartan (Diovan)

These are not complete lists of these medicines.

Possible side effects

All medicines can cause side effects.

These are some side effects of both angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).

• Low blood pressure. You may feel dizzy and weak.
• Kidney problems.
• High potassium levels.
• Swelling of your lips, tongue, or face. Rarely, swelling becomes severe and makes it hard to breathe. In this case, you may need treatment right away.

ACE inhibitors can also cause a chronic, dry, hacking cough.

You may have other side effects or reactions not listed here. Check the information that comes with your medicine, or ask your doctor or pharmacist about the side effects of each medicine you take.

What to know about taking this medicine

• Be safe with medicines. Take your medicines exactly as prescribed. Contact your doctor if you think you are having a problem with your medicine or if you missed a dose of a medicine.
• Before starting an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blockers (ARB), tell your doctor if you:
  • Use a salt substitute.
  • Take diuretics or potassium tablets.
• ACE inhibitors can cause a chronic, dry, hacking cough. If the cough is bad, talk to your doctor. Switching to an ARB is likely to help.
• Do not take these medicines if you are pregnant, breastfeeding, or planning to become pregnant.
• Taking some medicines together can cause problems. Tell your doctor or pharmacist all the medicines you take. This includes other prescription medicines, over-the-counter medicines, vitamins, supplements, and herbal remedies.
• You may need regular blood and urine tests to see if the medicines are causing any problems.