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ACE inhibitor monitoring — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsACE inhibitor monitoringGPhC CRA

A 58-year-old man asks for advice after being started on ramipril 2.5mg daily for hypertension. His baseline U&Es were normal and he also takes amlodipine 5mg daily. He reports no adverse effects after 5 days. What monitoring is required?

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Correct answer: B — Check renal function and serum potassium within 1 to 2 weeks

ACE inhibitors can reduce renal perfusion and increase serum potassium, particularly after initiation or dose escalation. U&Es should be checked soon after starting therapy, commonly within 1 to 2 weeks, and again after dose changes. Liver function and thyroid function are not routine safety monitoring for ramipril. HbA1c monitoring would relate to diabetes rather than ACE inhibitor safety.

Reference: BNF; NICE CKS Hypertension