In the same study, patients treated with lisinopril and hydrochlorothiazide for up to 24 weeks had a mean decrease in serum potassium of 0.
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US BOXED WARNINGS FETAL TOXICITYAngiotensin converting enzymeACEinhibitoruse during pregnancy can cause morbidity and death to the developing fetusWhen used during the second and third trimestersACE inhibitors have been associated with fetal and neonatal injuryincluding hypotensionneonatal skull hypoplasiaanuriareversible or irreversible renal failureand deathOligohydramnios has also been reportedpresumably resulting from decreased fetal renal functionoligohydramnios in this setting has been associated with fetal limb contracturescraniofacial deformationand hypoplastic lung developmentExposure to ACE inhibitors during the first trimester of pregnancy has been associated with prematurityintrauterine growth retardationpatent ductus arteriosusother structural cardiac malformationsand neurological malformationsWhen pregnancy is detectedACE inhibitors should be discontinued as soon as possibleIf no alternative to ACE inhibitor therapy is availablepatients should be made aware of therisks to their fetuses and the intra-amniotic environment should be evaluated by serial ultrasound examinationsIf oligohydramnios developsthis drug should be discontinued unless it is considered lifesaving for the motherDepending on the week of pregnancycontraction stress testinga nonstress testor biophysical profiling may be appropriateOligohydramnios may not show until after the fetus has suffered irreversible injury.
Feeling like you might pass outurinating less than usual or not at allswellingrapid weight gainfeverchillsbody achesflu symptomstired feelingmuscle weaknessand pounding or uneven heartbeatspsoriasisraisedsilvery flaking of the skinchest painor high potassiumslow heart rateweak pulsemuscle weaknesstingly feeling
In the ATLAS trialsee Clinical Studiesin heart failure patientswithdrawals for adverse reactions were similar in the low-and high-dose groupsThe following adverse reactionsmostly related to ACE inhibitionwere reported more commonly in the high dose group:
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