ACE inhibitors: important advice about serious swelling reactions

Last Updated: Monday, 12 October 2026

ACE inhibitors include ramipril, lisinopril, perindopril, captopril, fosinopril and trandolapril. They treat high blood pressure and heart failure, and can help protect the heart and kidneys.

The MHRA, the UK medicines regulator, has strengthened warnings about angioedema — swelling that can affect your face, lips, tongue or throat.

This reaction is uncommon or rare but can be life-threatening. It can happen even after years of taking the medicine without problems. It may occur without a rash or itching and is not always an allergic reaction.

What should you do?

Call 999 immediately if:

• Your lips, mouth, tongue or throat suddenly swell.
• You have difficulty breathing or swallowing, or your throat feels tight.

For swelling of your face, seek urgent medical attention immediately, even if your breathing is normal.

Do not take any further doses of your ACE inhibitor if this reaction is suspected. Tell the healthcare professional which medicine you take.

If an ACE inhibitor caused the reaction, it must not be restarted. Your clinician will arrange alternative treatment.

Want to discuss your medicine?

Contact your GP practice to book a medication review with a clinician if you have concerns. Tell them about any previous swelling reactions.

Do not wait for a routine review if swelling develops.

Read the full MHRA alert.