Ace Inhibitors Nutrient Depletion Checklist
Nutrient Depletion Checklist:

Ace Inhibitors

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Drug Nutrient Depletions Potential Health Problems

Lotensin® (captopril), Capoten®, Vasotec®, Prinovil®, Zestril® Zinc [1–3] Slow wound healing,   loss of sense of smell and taste,   lower immunity
  Sodium [4–6] Dehydration,   loss of appetite,   muscle weakness,   poor concentration.   Note:   Replacement not recommended (depletion due to therapeutic effect).


Potential Interactions
    Potassium.   May increase potassium levels [7] especially in combination with potassium-sparing diuretics (spironolactone) [8] or salt-substitutes [9] or potassium supplements. [10]
    Cayenne (Capsicum frutescens).   Coughing reported when cayenne (Capsicum frutescens) cream was applied in conjunction with the use of ace inhibitors. [11]
    Iron.   Iron supplementation inhibits cough associated with ACE inhibitors. [12–13]

ACE inhibitors
  1. Pelton R. LaValle JB. Drugs and Their Effects on Nutrition In: The Nutritional Cost of Prescription Drugs.
    2nd ed. Englewood, CO: Morton Publishing Company; 2004, 58.

  2. Golik A, Modai D, Averbukh Z, et al. Zinc metabolism in patients treated with captopril versus enalapril.
    Metabolism. 1990; 39:665–67.

  3. Golik A, Zaidenstein R, Dishi V, et al. Effects of captopril and enalpril on zinc metabolism in hypertensive patients. J Am Coll Nutr. 1998; 17:75–80.

  4. Pelton R. LaValle JB. The Quick Reference Guide to Nutrient Losses. In: The Nutritional Cost of Prescription Drugs. 2nd ed. Englewood, CO: Morton Publishing Company; 2004, 14.

  5. Egan BM, Stepniakowski K. Effects of enalapril on the hyperinsulinemic response to severe salt restriction in obese young men with mild systemic hypertension.
    Am J Cardiol 1993; 72:56–57.

  6. Izzedine H, Fardet L, Launay-Vacher V, et al. Angiotensin-converting enzyme inhibitor-induced syndrome of inappropriate secretion of antidiuretic hormone: case report and review of the literature.
    Clin Pharmacol Ther. 2002 Jun;71 (6) :503–7.

  7. Ohya Y, Ueno M, Takata Y, et al. Crossover comparison of the effects of enalapril and captopril on potassium homeostasis in patients with mild hypertension.
    Int J Clin Pharmacol Ther. 1994; 32:655–59.

  8. Cruz CS, Cruz AA, Macilio de Souza CA. Hyperkalaemia in congestive heart failure patients using ACE inhibitors and spironolactone.
    Nephrol Dial Transplant 2003 Sep;18(9) :1814–9.

  9. Ray K, Dorman S, Watson R. Severe hyperkalaemia due to the concomitant use of salt substitute and ACE inhibitors in hypertension: a potentially life threatening interaction.
    J Hum Hypertens. 1999 Oct;13(10):717–20.

  10. Chan TY, Critchley JA. Life-threatening hyperkalaemia in an elderly patient receiving captopril, furosemide and potassium supplements.
    Drug Saf. 1992 Mar-Apr;7 (2):159–61.

  11. Brinker F. Herb Contraindications and Drug Interactions. Sandy, Ore: Eclectic Institute; 2001:58.

  12. Lee SC, Park SW, Kim DK, et al. Iron supplementation inhibits cough associated with ACE inhibitors.
    Hypertension 2001 Aug; 38 (2):166–70.

  13. Basile JN. ACE inhibitor-associated cough lessened with iron supplementation.
    J Clin Hypertens 2002 Jan-Feb;4(1):49–50.

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