Int. Rev. Allergol. Clin. Immunol. Family Med., 2015, XXI/1: 042-047 Maximize

Int. Rev. Allergol. Clin. Immunol. Family Med., 2015, XXI/1: 042-047

Title: Side effects of ACE-inhibitors in the allergological practice 

Authors: Gomułka K, Siwak E, Wolańczyk-Mędrala A, Mędrala W

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Side effects of ACE-inhibitors in the allergological practice

Gomułka K1, Siwak E1,2, Wolańczyk-Mędrala A1, Mędrala W1.

Medical University of Wrocław, Poland: 1Chair and Department of Internal Diseases, Geriatry and Allergology; 2Chair and Department of Medical Biochemistry

Int. Rev. Allergol. Clin. Immunol. Family Med., 2015; Vol. 21, No. 1, 42

Angiotensin converting enzyme inhibitors (ACE-inhibitors) are nowadays widely used, especially in internal medicine and cardiology (treatment of hypertension, myocardial infarction, ischemic heart disease or heart failure) or in nephrology (used in the course of diabetic nephropathy and renal failure). Through the influence on the tension of the arterial smooth muscle they have a hypotensive effect, moreover they reduce preload and afterload of the heart, reduce the remodeling process of the myocardium, have a beneficial effect on the cardiovascular system, reduce sodium absorption and diminish microalbuminuria in patients with diabetes. Their wide and pleiotropic action is complicated by various side effects like headaches, dizziness, unstable blood pressure, hyperkalemia, exacerbation of renal insufficiency and teratogenic effects in pregnant women. In addition, it should be remembered that on the basis of sensitiveness drug from this group even in 10% of patients can cause cough, angioedema mainly on the face and non-allergic rhinitis. The detection of the sensitivity to ACEinhibitors could be confirmed by the challenge test in the hospital, but prevention consist on the avoidance of using the drugs from this group. It is also acceptable to replace the ACEinhibitors by angiotensin receptor blockers (ARBs). However, the risk of recurrence of angioedema is higher in this group of patients.

Key words: angiotensin converting enzyme inhibitors, side effects, non-allergic rhinitis, angioedema, chronic cough