Drug-induced angioedema

Drug-induced angioedema is a known complication of the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II antagonists (ARBs), and some neprilysin inhibitors. The angioedema appears to be dose dependent as it may resolve with decreased dose.

Presentation

Angioedema presents itself as an abrupt onset of non-pitting, non-itchy swelling that involves the mucosal layers. Some common locations of angioedema are the face, particularly the lips and around the eyes, hands and feet, and genitalia. A rare, yet serious complication is one inside the abdomen, the symptom usually being severe stomach upset, which is much less obvious than the other locations.

Risk factor

Some common ACE Inhibitors are:

Some common ARBs are:

Incidence

Cases of drug-induced angioedema are uncommon, with studies showing an incidence of less than 1%. The reason this adverse effect may occur is due to the build-up of bradykinin, a vasodilator. This causes blood vessels to dilate and allows for fluid buildup in the mucosal surfaces.