High Blood Pressure Best Buys in ACE Inhibitors

High blood pressure (hypertension) can be caused by obesity, genetics, stress, lack of exercise or a combination of many factors. ACE (Angiotensin-Converting Enzyme) inhibitors are drugs that help control blood pressure and may be prescribed for other conditions.

Top Three ACE Inhibitor Drugs

About a dozen ACE inhibitors are on the market, with good effectiveness reports. Some are more expensive than other and may not have generic equivalents. If insurance may be involved, choices may be much fewer than doctor or patient may hope for.

Like with any prescription, doctors generally consider drug effectiveness, price and safety when ordering any prescription. The top three best buys, especially regarding cost to patient according to Consumer Reports, June 2009, page 10, the best buys of generic ACE inhibitors are:

lisinopril (lye-sin-oh-pril) also known by brand names Prinzide®, Zestoretic®

benazepril (ben-ay-ze-pril) or brand name Lotensin®

enalapril (e- NAL-a-pril) generic, offered also as the brand name Vasotec®

What to Expect

According to the American Heart Association (AMA), ACE inhibitors decrease certain chemicals in the body to help blood flow through the heart and blood vessels. Expect to take this drug once-a- day, about the same time each day. If a dose is skipped, take it as soon as possible, unless it is nearly time to take the next dose. These medications control hypertension, but not cure it. If not already doing so, plan to avoid salt, potassium supplements (unless ordered by doctor), salt substitutes and alcohol. Expect the doctor to ask for a complete list of drugs, vitamins and herbal supplements.

According to Epocrates.com and Drugs.com avoid taking any ACE inhibitors with lithium, azathioprine, thiazide combinations, other ACE inhibitors or other types of hypertension drugs. Common medications and supplements which may cause a problem and should be discussed include:

• capsicum
• black cohosh
• diabetic medicines taken by mouth and insulin
• diuretic (water pill)
• arthritis drugs (particularly gold-based injections)
• kava
• lithium (Lithobid, Eskalith)
• potassium supplement
• salt substitutes (which may contain potassium)
• if considering enalapril, the doctor needs to know about use of pain relievers like aspirin, ibuprophen, and naproxen, or any in the NSAID group of drugs Do not use this medication if you are allergic to lisinopril or to any other ACE inhibitor)
• other medications may also be on the caution list

Expect possible dose adjustments or special tests with these conditions:

• diabetes
• heart disease of any kind
• kidney disease (or on dialysis)
• liver disease
• connective tissue disease (rheumatoid arthritis, lupus, scleroderma or others)

Side Effects and Serious Reactions

Everything consumed effects the body, but some are more bothersome than others. Some side effects of these three ACE inhibitors include: cough, dizziness, rash, headache, runny nose, excessive tiredness, decreased sexual ability, nausea, diarrhea, and weakness, according to the report by American Society of Health-System Pharmacists (ASHP) at the National Center of Biotechnology Information (NCBI).Uncommon, but serious reactions can happen, and immediate medical help is needed, per recommendation by the NCBI: * difficulty breathing or swallowing* swelling of lips, eyes, face, throat, tongue, ankles, feet, hands or lower legs* yellowing of skin or eyes * lightheadedness, fainting

Look-alike or sound-alike drugs

Taking the wrong drug can be deadly. These ACE inhibitors can be confused with one another and with other drugs, so it is important to check the drug use, name and appearance with the pharmacist when picking up the medication:

Benazepril can also be confused with: Benadryl; Benicar; benzonatate; benztropine; donepezil

Enalapril can also be confused with: allopurinol; Anafranil; captopril; Elavil; Eldepryl; escitalopram; Prinivil; quinapril; ramipril; verapamil

Lisinopril can also be confused with: famotidine; fosinopril; linezolid; Lipitor; losartan; lovastatin; Monopril; quinapril; Restoril; Risperdal; verapamil

The Bottom Line

There are about a dozen ACE inhibitors available and other kinds of drugs which may help keep hypertension under control. Each patient is different and may need to try several different medications before the right one is discovered. The three highlighted drugs work well and are cost effective, in Consumer Reports June '09 issue on health. Vigilance is the key to good health and keeping the silent killer of hypertension under control.

Sources

http://www.drugs.com
http://www.medicalnewstoday.com
http://americanheart.org
http://www.webmd.com
http://www.ncbi.nlm.nih.gov
http://www.amcp.org

Disclaimer

Online health magazine articles do not replace consultation and treatment with a licensed health professional for these and any medical condition. Always seek advice and diagnostics through a licensed doctor. The author was not compensated in any way by any pharmaceutical company prior to/in the process of developing this health information article.