A GP and television doctor has warned millions of people taking ACE inhibitor drugs, such as ramipril, about a rare but potentially serious side-effect. The alert follows a safety update from the Medicines and Healthcare Products Regulatory Agency (MHRA) highlighting the risk of angioedema, a condition causing swelling of the lips, face, tongue or throat.
Dr Mark Porter, a regular on The One Show and BBC Radio 4's Inside Health, explained that angioedema occurs in between one in 1,000 and one in 140 cases. In severe reactions, it can lead to difficulty swallowing and breathing, and can be life-threatening. Those most at risk include women, people over 65, smokers, and those of black or African-Caribbean ethnicity.
The MHRA warning emphasises that the reaction can be delayed, occurring weeks or even months after starting the medication. Dr Porter noted that it is easily confused with anaphylaxis but often requires different emergency treatment, as conventional approaches like adrenaline injections may not work.
Aside from angioedema, a far more common side-effect is a chronic dry cough, affecting about one in ten users. This cough can persist for weeks or months and is often missed or attributed to other conditions. Dr Porter advised that switching to a similar family of drugs called sartans typically resolves the cough within a few weeks.
Dr Porter also cautioned against taking ACE inhibitors alongside non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, as this combination can lead to serious kidney problems in some individuals.
