Who should avoid using ACE inhibitors?
• People with the following should not take ACE inhibitors: • History of anuria or angio-oedema with previous exposure to the drug. • Bilateral renal stenosis. • ACE inhibitors and AIIRAs are contraindicated at any stage during pregnancy. • ACE inhibitors and AIIRAs are not recommended for use by women who are breastfeeding, especially during the first few weeks after delivery. • In women who are breastfeeding older infants, the use of captopril, enalapril, or quinapril may be considered. • If used, the infant should be carefully followed up for signs of hypotension. • Seek specialist advice if the person: • Is on high-dose diuretics (equivalent to 80 mg furosemide or above) or high-dose vasodilators. • Has hypovolemia; sodium below 130 mmol/L; or systolic blood pressure of 90 mmHg or less. • Has unstable heart failure or severe aortic stenosis. • If baseline creatinine or potassium is raised (i.e. creatinine more than 200 micromoles/L or potassium 5.5 mmol/L or more), monitor closely
