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Medications

Renin-Angiotensin-System (RAS) Blockers — ACEi & ARB

Last Updated on May 22, 2022

Ace Inhibitors (ACEIs)

Benefits

• Can lower cardiovascular risk
• Can prevent coronary artery disease in patients with HTN
• Can reduce mortality & morbidity in patients with congestive heart failure
• No adverse effect on lipid & glucose metabolism

Adverse effects

• Dry cough
• Angioedema (rare)
Deterioration of renal function

Doses

ACEi

Starting dose

Recommended maximum daily dose

Remark

Captopril

25 mg BD

50 mg TDS

Enalapril

10 mg OD

40 mg OD

Lisinopril

10 mg OD

80 mg OD

Perindopril

• 4 mg OD (as erbumine)
• 5 mg OD (as arginine)

• 8 mg OD (as erbumine)
• 10 mg OD (as arginine)


Ramipril

2.5 mg OD

10 mg OD

Imidapril

5 mg OD

20 mg OD

Precautions

• Check baseline renal profile before starting
Re-check renal profile within 2 weeks

Angiotensin Receptor Blockers (ARBs)

Benefits

• Persistent dry cough is less compared to ACEi

Doses

ARB

Starting dose

Recommended maximum daily dose

Remark

Candesartan

8 mg OD

32 mg OD

Irbesartan

150 mg OD

300 mg OD

Losartan

50 mg OD

100 mg OD

Telmisartan

40 mg OD

80 mg OD


Valsartan

80 mg OD

320 mg OD

Olmesartan

20 mg OD

40 mg OD

Precautions

• Combination of ACEI and ARB is not recommended and is to be avoided

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