When are ACE inhibitors prescribed?
The ACE inhibitors are valuable drugs in the therapy of high blood pressure. The combination of an ACE inhibitor with a diuretic is recommended because an additional increase in effectiveness can be achieved and better blood pressure values can be set. It is important that the patient is informed about the fact that in the first phase of therapy side effects such as fatigue and exhaustion often occur, but these usually disappear again in the course of therapy and as the body gets used to lower blood pressure values.
Patients with a functional impairment of the heart, known as cardiac insufficiency, prefer to receive ACE inhibitors, as these have a protective and relieving effect on the heart. The course of disease in this group of patients can be positively influenced. ACE inhibitors are also recommended for the follow-up treatment of patients with myocardial infarction and for diabetic patients who suffer from kidney dysfunction (diabetic nephropathy) as a result of diabetes: Heart remodelling processes that occur after a heart attack or in the case of high blood pressure can be inhibited by the drugs, so that, for example, thickening of the heart muscles is reduced. In diabetics with kidney damage, the ACE inhibitors prevent the rapid progression of kidney disease and reduce the excretion of proteins. Diabetics also benefit from therapy with ACE inhibitors in that the group of drugs has a beneficial effect on fat and sugar metabolism in the sense of reducing sugar and fat levels.
Drug group of the ACE inhibitors
ACE inhibitors include the following active substances with the corresponding trade names of the preparations. The trade names are the names of the pharmaceutical companies for their preparations with a special active substance from the group of ACE inhibitors. Drug group of the ACE inhibitors and their trade names
- Benazepril, e.g.
Cibacen®, Benzepril Hexal®, Benazepril Beta®
- Captopril, e.g. Coronorm®, Lopirin®, Ace inhibitor ratio. ®, Adocor ®, Captohexal ®, Core tensobon®, Jucapt ®
- Cilazapril, Dynorm®
- Enalapril, e.g. Enadura®, Xanef®, Corvo®, Benalapril®, Enadura®, Jutaxan®, Enahexal®, Enalapril-ratio®
- Fosinopril, for example Dynacil®, Fosinorm®, Fosinopril Basics®, Fosinorm®, Fosino Teva®. – Imidapril, Tanatril®
- Lisinopril, e.g.
Acerbon®, Coric®,Acerbon®, Coric®, Lisidigal®, Lisidura®, Lisihexal®, Lisigamma®
- Moexipril, Fempress®
- Perindopril, e.g. Coversum®
- Quinapril, e.g. Accupro®, Quinapril Beta®, Quniapril Hexal®, Quinapril Stada®. – Ramipril, e.g. Delix®, Ramicard®, Delix®, Rami-Q®, Ramicard®, Vesdil®, ramipril ratio. ®, Ramipril Hexal®
- Spirapril, Quadropril®
- Trandolapril, Udrik®
Combination treatment of high blood pressure
ACE inhibitors can be used as so-called monotherapeutics, which means that the ACE inhibitor is the only drug used to reduce high blood pressure. The following dual combinations consisting of an ACE inhibitor and another drug are recommended for high blood pressure: ACE inhibitor and calcium antagonist, ACE inhibitor and diuretic. Calcium antagonists lower blood pressure by acting on the blood vessels in the sense of vasodilatation, and they also have some effect on the heart.
A diuretic is a drug used to increase water excretion with urine. This group of drugs is often called “water tablets”. If none of the twofold combinations works sufficiently, a triple combination can be prescribed. This can consist of: Diuretic and ACE inhibitor and angiotensin-2 antagonist, diuretic and ACE inhibitor and calcium antagonist. The angiotensin-2 antagonist is a drug whose effect is similar to that of the ACE inhibitors: It affects the RAAS and lowers blood pressure by dilating blood vessels and reducing water retention in the body.