Cardiovascular medications
Dental Considerations for Patients Taking ACE inhibitor (e.g. lisinopril/ramipril)
Routine care — note drug considerations (ACE inhibitor)
Record of ACE inhibitor. The points below cover relevant oral side-effects and drug interactions so prescribing and treatment remain safe and non-conflicting.
Emergency vs routine management
If EMERGENCY — what to do
- • Lip/tongue swelling (ACE-inhibitor angioedema) is an airway emergency — call emergency services, adrenaline 0.5 mg IM if anaphylaxis suspected.Ref: Resuscitation Council UK. Medical emergencies and resuscitation — Standards for dental practice, 2020 (updated 2023)
- • Avoid NSAIDs; use paracetamol for analgesia.Ref: SDCEP. Drug Prescribing for Dentistry, 3rd ed. (2016, updated 2021)
If ROUTINE — what to do
- • Routine care; avoid NSAIDs for > 3 days (renal risk, reduced effect).Ref: British National Formulary (BNF) — Prescribing in renal impairment, hepatic impairment & drug interactions (current edition)
Clinical precautions
- • Avoid NSAIDs (reduced antihypertensive effect + renal risk); prefer paracetamol.
- • Possible dry cough or (rarely) angioedema — be alert to oral/lip swelling.
- • Avoid prescribing drugs that interact; verify any new prescription against the patient's full medication list.
At a glance by procedure
Initial assessment before lab results or timing details are entered.
| Procedure | Initial assessment |
|---|---|
| Examination / radiographs | ROUTINE Routine care — note drug considerations (ACE inhibitor) |
| Supragingival scaling / polish | ROUTINE Routine care — note drug considerations (ACE inhibitor) |
| Deep scaling / subgingival RSD (subgingival calculus) | ROUTINE Routine care — note drug considerations (ACE inhibitor) |
| Root canal treatment | ROUTINE Routine care — note drug considerations (ACE inhibitor) |
| Simple extraction (1–3 teeth) | ROUTINE Routine care — note drug considerations (ACE inhibitor) |
| Surgical / bony extraction | ROUTINE Routine care — note drug considerations (ACE inhibitor) |
| Implant placement | ROUTINE Routine care — note drug considerations (ACE inhibitor) |
References
- Drug considerations in dentistry (oral side-effects & interactions)
- Resuscitation Council UK. Medical emergencies and resuscitation — Standards for dental practice, 2020 (updated 2023)
- SDCEP. Drug Prescribing for Dentistry, 3rd ed. (2016, updated 2021)
- British National Formulary (BNF) — Prescribing in renal impairment, hepatic impairment & drug interactions (current edition)
Related guides
This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.