ACE Inhibitors advice
Important Information for Patients Taking ACE Inhibitors
ACE inhibitors are medicines commonly used to treat high blood pressure, heart failure, and other heart and kidney conditions. Examples include ramipril, lisinopril, enalapril, perindopril, and captopril.
Although uncommon, ACE inhibitors can sometimes cause a condition called angioedema. This is a swelling that usually affects the face, lips, tongue, throat, or sometimes the stomach and bowel.
What Is Angioedema?
Angioedema is sudden swelling beneath the skin or lining of the body. It can affect:
- Lips
- Tongue
- Face
- Throat
- Voice box (larynx)
- Stomach or bowel (causing abdominal pain)
In some cases, the swelling can become serious and make it difficult to breathe or swallow.
When Can It Happen?
Angioedema can occur:
- Shortly after starting an ACE inhibitor
- After months of treatment
- Even after several years of taking the medicine without any previous problems
Because it can happen at any stage of treatment, it is important to remain aware of the symptoms.
Symptoms to Watch For
Seek urgent medical attention if you develop:
- Swelling of the lips, tongue, face, or throat
- Difficulty breathing
- Difficulty swallowing
- A feeling that your throat is tightening
- Sudden unexplained abdominal pain or stomach cramps
Why Does It Happen?
There are two main types of angioedema:
1. Allergic (Histamine-Mediated) Angioedema
This is caused by an allergic reaction.
2. Non-Allergic (Bradykinin-Mediated) Angioedema
This can occur in some people taking ACE inhibitors. It is less common but is important because it may not respond to the usual treatments given for allergic reactions.
Healthcare professionals will assess which type is most likely and provide appropriate treatment.
What Should I Do If I Develop Symptoms?
Stop Taking the ACE Inhibitor
If angioedema is suspected:
- Do not take any further doses of your ACE inhibitor.
- Seek urgent medical attention immediately.
- Tell healthcare professionals that you are taking (or have been taking) an ACE inhibitor.
Will I Be Able to Take the Medicine Again?
If your healthcare professional confirms that your angioedema was caused by an ACE inhibitor, the medicine should not be restarted. Your doctor will discuss alternative treatment options with you.
Key Messages
✅ Angioedema is an uncommon but potentially serious side effect of ACE inhibitors.
✅ It can occur at any time, even after years of treatment.
✅ Swelling of the face, lips, tongue, or throat requires urgent medical attention.
✅ Do not take further doses if angioedema is suspected.
✅ Always inform healthcare professionals if you have previously experienced angioedema while taking an ACE inhibitor.
Source: Medicines and Healthcare products Regulatory Agency (MHRA), Drug Safety Update: ACE-inhibitors: Be aware of the distinction between bradykinin- and histamine-mediated angioedema, as treatment strategies differ significantly (16 June 2026).