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Should people with certain allergies avoid angiotensin-converting enzyme (ACE) inhibitors?

Last Updated 3/3/2023

Treatment

Angiotensin-converting enzyme (ACE) inhibitors are safe for people with most types of allergies.

You should NOT take an angiotensin-converting enzyme (ACE) inhibitor if:

You have ever had an allergic reaction to taking an ACE inhibitor in the past
You have ever had a specific kind of swelling called angioedema

Always discuss any allergies you have with your doctor.

Telling your doctor is the key when you have an allergy!

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Authors

Lisa Souza, M.L.I.S.

Weill Cornell Medicine

Amanda S. Carmel, M.D.

Weill Cornell Medicine

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What are the serious side effects of angiotensin receptor blockers (ARBs)?

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See what you learned!

Answer this question to help us make PALS better.

Which one of these means you should not take an ACE inhibitor?

You've been allergic to an ACE inhibitor in past

This is correct!

You're allergic to animal dander

This is incorrect. You only need to avoid ACE inhibitors if you've had an allergic reaction to ACE inhibitors in the past or if you've ever had angioedema.

You're allergic to pollen

This is incorrect. You only need to avoid ACE inhibitors if you've had an allergic reaction to ACE inhibitors in the past or if you've ever had angioedema.

You're allergic to bee stings

This is incorrect. You only need to avoid ACE inhibitors if you've had an allergic reaction to ACE inhibitors in the past or if you've ever had angioedema.

I don’t know

You only need to avoid ACE inhibitors if you've had an allergic reaction to ACE inhibitors in the past or if you've ever had angioedema.

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See the Science

Angiotensin-converting enzyme (ACE) inhibitors are contraindicated in patients:

who are hypersensitive to any variety of ACE inhibitor
with a history of angioedema with or without previous ACE inhibitor treatment^1-14

Acquired angioedema related to ACE inhibitors is swelling most often localized to the face, followed by lips, eyelids, tongue, neck, and upper airways.¹⁵

References

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Qbrelis [package insert]. Wilmington, MA: Azurity Pharmaceuticals, Inc.; 2020.
Prinivil [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2021.
Zestril [package insert]. Morristown, NJ: Almatica Pharma LLC; 2020.
Univasc [package insert]. Smyrna, GA: USB, Inc; 2012.
Aceon [package insert]. Cincinnati, OH: Patheon Pharmaceuticals, Inc.; 2017.
Accupril [package insert]. New York, NY: Parke Davis, Pfizer; 2021.
Altace [package insert]. New York, NY: Pfizer Laboratories; 2022.
Mavik [package insert]. Whippany, NJ: Halo Pharmaceutical Inc.; 2017.
Cicardi M, Aberer W, Banerji A, et al. Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group. Allergy 2014; 69 (5): 602-616.

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