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The Drug-Induced Cardiotoxicity Website and App

Angiotensin converting enzyme inhibitors (ACEI)

Specialities: Cardiology - Cardiovascular medicine · Family medicine · General Practice · Internal medicine

The spectrum of angiotensin converting enzyme inhibitor-induced problems is huge. Cough and angioedema w/wo UAO are the most typical AE from ACEIs. Upper arway angioedema and closure is the most dreadful one. A few cases were described with ARBs. See under each specific ACEI drug. Icatibant is an effective drug in angioedema cases (PMID: 25646708)

Frequency - Incidence

Incidence of cardiac adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for cardiac adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

XII - Pericardial involvement

XII.g

Pleural/pericardial effusion, ANA positive (DI lupus)

XIV - Pleural involvement

XIV.a

Pleural effusion (uni- or bilateral) (can accompany DI-LDs)
XIV.d

Eosinophilic pleural effusion

XIX - Angioedema

XIX.b

Visceral angioedema (can cause relapsing abdominal pain)

XXIV - Interstitial lung disease - Pulmonary infiltrates - Pulmonary fibrosis

XXIV.a

Pneumonitis (interstitial lung disease/ILD)
XXIV.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)

XXVIII - Large airway involvement including UAO

XXVIII.a

Angioedema (may cause UAO, asphyxia and death)
XXVIII.i

Tongue involvement (edema, glossitis, hematoma)

XXIX - Small airway involvement

XXIX.a

Bronchospasm - Wheezing - Asthma
XXIX.c

Severe or catastrophic bronchospasm or asthma attack (can be fatal)
XXIX.d

Cough (lone)

XXX - Imaging features

XXX.c

Imaging: Upper/central airway narrowing

XXXI - Eye catchers

XXXI.a

Eye-catcher: Tongue edema

XXXV - Disordered breathing during sleep

XXXV.b

Disordered breathing pattern incl. Cheyne-Stokes respiration
XXXV.c

Obstructive sleep apnea

XXXVI - Autoimmune syndromes - Systemic reactions or conditions

XXXVI.b

Lupus - Lupus syndrome (see also Vd)

XXXVIII - Miscellaneous - Varia

XXXVIII.b

Hemilingual (angio)edema
XXXVIII.i

Cough syncope