Alternative Medicine
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An asterisk (*) next to an item in the summary
indicates that the interaction is supported only by weak, fragmentary,
and/or contradictory scientific evidence.
An uncommon yet potentially serious side effect of taking ACE inhibitors is increased blood potassium levels.1, 2, 3 This problem is more likely to occur in people with advanced kidney disease. Taking potassium supplements,4 potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others),5, 6, 7 or large amounts of high-potassium foods at the same time as ACE inhibitors could cause life-threatening problems.8 Therefore, people should consult their healthcare practitioner before supplementing additional potassium and should have their blood levels of potassium checked periodically while taking ACE inhibitors.
Sodium
In a short-term study of nine overweight men, enalapril plus a low-salt diet reduced blood pressure more than a low-salt diet alone.9 Additionally, enalapril plus a low-salt diet resulted in better insulin response than the low-salt diet alone. The importance of this preliminary information for overweight people with high blood pressure is unclear.
In a double-blind study of patients who had developed a cough attributed to an ACE inhibitor, supplementation with iron (in the form of 256 mg of ferrous
sulfate per day) for four weeks reduced the severity of the cough by a statistically significant 45%, compared with a nonsignificant 8% improvement in the placebo group.10
Ray K, Dorman S, Watson R. Severe hyperkalemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction. J Hum Hypertens 1999;13:717-20.
Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1965-8.
Stoltz ML. Severe hyperkalemia during very-low-calorie diets and angiotensin converting enzyme use. JAMA 1990;264:2737-8 [letter].
Egan BM, Stepniakowski K. Effects of enalapril on the hyperinsulinemic response to severe salt restriction in obese young men with mild systemic hypertension. Am J Cardiol 1993;72:53-7.
Lee SC, Park SW, Kim DK, et al. Iron supplementation inhibits cough associated with ACE inhibitors. Hypertension 2001;38:166-70.
Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihypertensives, Angiotensin Converting Enzyme Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1998, 165o-5p.
The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires August 2007.
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