Should angiotensin-converting enzyme (ACE) inhibitors be taken with or without food?

Most angiotensin-converting enzyme (ACE) inhibitors can be taken with or without food, including benazepril, enalapril, enalaprilat, fosinopril, lisinopril, perindopril, quinapril, ramipril, and trandolapril.^1,3-9,11-14

The presence of food in the gastrointestinal tract reduces absorption of captopril by about 30-40% and moexipril by 40-50%. Manufacturers recommend administering one hour before meals to maximize bioavailability.^2,10

References

1. Lotensin [package insert]. Parsippany, NJ: Validus Pharmaceuticals LLC; 2019.
2. Capoten [package insert]. Chestnut Ridge, NY: Par Pharmaceutical; 2017.
3. Epaned [package insert]. Wilmington, MA: Azurity Pharmaceuticals, Inc.; 2020.
4. Vasotec [package insert]. Bridgewater, NJ: Bausch Health US LLC; 2018.
5. Enalaprilat [package insert]. Lake Forest, IL: Hospira, Inc.; 2021.
6. Monopril [package insert]. Princeton, NJ: Bristol-Myers Squibb Company; 2003.
7. Qbrelis [package insert]. Wilmington, MA: Azurity Pharmaceuticals, Inc.; 2020.
8. Prinivil [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2021.
9. Zestril [package insert]. Morristown, NJ: Almatica Pharma LLC; 2020.
10. Univasc [package insert]. Smyrna, GA: USB, Inc; 2012.
11. Aceon [package insert]. Cincinnati, OH: Patheon Pharmaceuticals, Inc.; 2017.
12. Accupril [package insert]. New York, NY: Parke Davis, Pfizer; 2021.
13. Altace [package insert]. New York, NY: Pfizer Laboratories; 2022.
14. Mavik [package insert]. Whippany, NJ: Halo Pharmaceutical Inc.; 2017.