How Do ACEI-CCB Combos Work?

Angiotensin-converting enzyme inhibitor/calcium channel blocker (ACEI/CCB) combination drugs are used to treat high blood pressure. Hypertension is one of the major risk factors for cardiovascular disease, kidney disease, and stroke.

ACEIs work by inhibiting angiotensin-converting enzyme (ACE). This enzyme converts a signal protein in the body, angiotensin I to angiotensin II. Angiotensin II is a substance that narrows the blood vessels and contributes to salt and water retention in the body, thus increasing blood pressure. ACEI blocks the action of angiotensin II and dilates the blood vessels, which in turn lowers the blood pressure. ACEI also blocks the action of ACE and stops the breaking down of bradykinin. An increase in bradykinin levels causes the widening of blood vessels and helps decrease blood pressure.

CCBs also known as calcium channel antagonists work by blocking the entry of calcium into the cells through voltage-gated calcium channels present in the smooth muscle of arteries and heart muscles. The calcium that enters the cell causes contractions of the muscles in the heart and arteries. CCBs widen the arteries, as a result, free flow of blood increases and this leads to decreased blood pressure.

ACEI/CCB combos are used to treat hypertension (high blood pressure) in patients whose blood pressure is not adequately controlled on monotherapy (single drug therapy) or as initial therapy in patients likely to need multiple drugs to achieve blood pressure goals.

Side effects associated with ACEI/CCB combos may include:

• Headache
• Fatigue
• Lightheadedness
• Fainting
• Swelling of hands, ankles, or feet
• Dry cough
• Nausea and vomiting
• Abdominal pain
• Dark-colored urine
• Urine volume changes
• Yellowing of skin and eyes
• Severe allergic reactions
• Dizziness
• Trouble breathing
• Upper respiratory tract infections
• Hypotension (low blood pressure)
• Hyperkalemia (increased potassium levels in the blood)
• Tachycardia (rapid, irregular heartbeat)
• Bradycardia (low heart rate)
• Kidney dysfunction
• Liver dysfunction
• Severe chest pain
• Decrease in white blood cells
• Angioedema (rapid edema, or swelling, of the area beneath the skin)

The information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of ACEI/CCB combos drugs include:

• Benazepril/amlodipine (Lotrel)
• Perindopril/amlodipine (Prestalia)
• Trandolapril/verapamil (Tarka)