How Do ACEI-Diuretic Combos Work?

Angiotensin-converting enzyme inhibitor/diuretic (ACEI/diuretic) combination drugs are used to treat high blood pressure. They work by relaxing blood vessels and removing excess water and salt from the body.

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, leading to increased blood pressure. ACEIs block the action of angiotensin II and dilate the blood vessels, which in turn lowers the blood pressure.

Diuretics also known as water pills are drugs that cause diuresis (increase in the production of urine by the kidneys). The diuretic component present in this combination drug works on the ascending limb of the loop of Henle of nephrons in the kidneys and eliminates sodium, chloride, and water from the body as urine. This results in decreased blood pressure as the blood volume decreases.

ACEI/diuretic combos are used to treat hypertension (high blood pressure) in patients not adequately controlled with monotherapy (single drug therapy),

Side effects of ACEI/diuretic combos may include:

• Dizziness
• Headache
• Fatigue
• Vertigo
• Tinnitus
• Dry cough
• Dry mouth
• Upper respiratory tract infections
• Nausea and vomiting
• Palpitations
• Flushing
• Dyspepsia
• Anorexia
• Constipation
• Paresthesia
• Muscle weakness
• Back pain
• Neck pain
• Fever
• Chills
• Rash
• Sexual dysfunction

Serious side effects of ACEI/diuretic combos may include:

• Hypokalemia (decreased potassium levels in the blood)
• Hyperglycemia (high blood sugar)
• Hyperuricemia (high uric acid levels in the blood)
• Parathyroid gland changes
• Syncope
• Tachycardia (rapid, irregular heartbeat)
• Peripheral vascular disorder (narrowing of blood vessels because of fat deposits in the wall and reducing blood flow to the limbs)
• Arthritis (inflammation and swelling of joints)
• Urinary tract infections
• Pancreatitis (inflammation of the pancreas)
• Anaphylactic shock (life-threatening allergic reaction caused by food or drugs)
• Thrombocytopenia (decreased platelet count)

Rare but serious side effects of ACEI/diuretic combos may include:

• Exfoliative dermatitis (severe inflammation of the skin)
• Toxic epidermal necrolysis (a life-threatening skin condition characterized by widespread redness and death of skin tissue)
• Erythema multiforme (autoimmune skin reaction caused by medicine)
• Steve-Johnson syndrome (severe skin reaction where skin and mucous membranes are damaged)

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/diuretic combos include:

• Benazepril/hydrochlorothiazide (Lotensin HCT)
• Captopril/hydrochlorothiazide (Capozide)
• Enalapril/hydrochlorothiazide (Vaseretic)
• Fosinopril/hydrochlorothiazide
• Lisinopril/hydrochlorothiazide (Zestoretic)
• Moexipril/hydrochlorothiazide (Uniretic)
• Quinapril/hydrochlorothiazide (Accuretic)