Precautions Need to be Observed while Taking ACE Inhibitors

Patient/caregiver was educated on precautions to be observed while taking ACE inhibitors as follows:

1. Drink 2.5 liters to 3 liters of fluid every day, as ACE inhibitors tend to cause loss of fluid volume and consequently, dehydration. If fluid is restricted in an individual for reasons, such as, congestive heart failure or dialysis dependent status, compliance to the recommendation made is very important.
2. Be aware of signs and symptoms of dehydration and hypotension, to avoid any episodes of loss of consciousness and accidental falls. One should stay away from activities, such as, driving and operating heavy machinery, until they are used to the side effects caused by the ACE inhibitor.
3. Try changing the positions very slowly, as sudden change of positions can make the hypotensive episodes even worse and precipitate accidents and falls.
4. ACE inhibitors increase potassium levels in the body. Be cautious about using any potassium supplements or any medications that increase the potassium levels in the body, such as, Spironolactone/Aldactone. Too high levels of potassium can be toxic to heart leading to complete heart block.
5. ACE inhibitors cause loss of sodium from the body and result in hyponatremia. Patients can present with nausea and vomiting, extreme lethargy, muscle cramps, weakness, and fatigue secondary to very low sodium levels in the body. Be aware of these symptoms and report them to the physician without delay.
6. Observe compliance with regular lab work ordered. Since the drug can lead to high potassium levels in the body, potassium levels in the blood could be closely monitored. Also, as kidneys are the main source of elimination of this drug, renal function could be periodically monitored.
7. Keep a watch on the volume of urine output, at least for the initial one month or two of starting on this medication. Void into a urinal and keeping a log of the volume on every voiding. Report to your physician, in case any gross diminishing in urine volume has been noted.
8. Take a blood pressure reading always before you take the pill. Maintain a log of every day blood pressure reading. If the blood pressure is too low, you can defer taking the medication for that dose. Notify your doctor, if more of such occurrences are happening, so that, your medication dose could be revised.
9. If a dose is missed, it should be taken at the earliest notice of noncompliance. If it is time for the next dose, the missed dose can be skipped. Compensating for the missed dose by taking an extra dose can pose serious risk for an episode of extremely low blood pressure.