Drug class·ACE Inhibitors & ARBs·Reviewed June 9, 2026
ACE inhibitors, ARBs, and supplements: mind the potassium.
The recurring theme for this blood-pressure class is potassium: these drugs make the body retain it, so potassium supplements and even heavy potassium-salt substitutes can stack toward hyperkalemia. Additive blood-pressure effects from other supplements are the second theme. Per-drug details below.
ACE Inhibitors & ARBs at a glance.
A quick, data-grounded summary. The per-drug tables are below.
Across the 14 ACE inhibitors and ARBs in the NutriStack database (Lisinopril, Losartan, Enalapril, Captopril, and Ramipril and 9 more), 27 substances have a documented interaction, 2 of them flagged to avoid or as a serious conflict. Long-term use of some medications in this class is also associated with lower Zinc and Sodium; the depletion table shows exactly which drugs. Interactions are documented per drug, and members of a class do not all behave the same, so check your exact medication below. None of this replaces your prescriber's advice.
The ACE inhibitors and ARBs we track.
Open any medication for its own full interaction and depletion guide.
Substances that interact with ACE inhibitors and ARBs.
Merged across the class, highest severity first. The 'Documented for' column shows which members carry the interaction record; an absent drug means no documented record, not proven safety.
| Substance | Interaction | Documented for | What happens |
|---|---|---|---|
| Potassium | Conflict | All 14 ACE inhibitors and ARBs | Losartan: Losartan blocks angiotensin II type 1 receptors, reducing aldosterone secretion and thereby decreasing renal potassium excretion. Adding... |
| St. John's Wort | Conflict | Losartan | Losartan is a prodrug metabolized by CYP2C9 and CYP3A4 to its active metabolite E-3174, which is 10-40 times more potent than the parent... |
| Garlic Extract | Caution | Lisinopril, Losartan, Enalapril +6 more | Captopril: Garlic extract has modest blood-pressure-lowering properties and may add to the antihypertensive effect of captopril. While this can be... |
| Lithium Orotate | Caution | Losartan, Enalapril, Ramipril +5 more | Losartan: Losartan blocks the AT1 receptor and reduces sodium reabsorption, which causes the kidney to retain lithium. A published case described a... |
| L-Citrulline | Caution | Lisinopril, Captopril, Candesartan +3 more | Captopril: L-Citrulline may add to the blood-pressure-lowering effect of Captopril. |
| Magnesium Glycinate | Caution | Captopril, Candesartan, Perindopril +2 more | Captopril: Magnesium Glycinate may add to the blood-pressure-lowering effect of Captopril. |
| Zinc | Caution | Lisinopril, Losartan, Enalapril +2 more | Lisinopril: ACE inhibitors as a class increase urinary zinc excretion and lower intracellular zinc over months of use. A systematic review of zinc and... |
| Coenzyme Q10 | Caution | Lisinopril, Enalapril, Ramipril +1 more | Candesartan: Coenzyme Q10 has shown a mild blood-pressure-lowering effect in some trials. When combined with candesartan, the antihypertensive effect... |
| Iron | Caution | Lisinopril, Captopril, Perindopril +1 more | Perindopril: ACE inhibitors are associated with a dry cough thought to involve bradykinin and substance P accumulation. Small studies suggest oral or... |
| Zinc Picolinate | Caution | Lisinopril, Enalapril | Lisinopril: ACE inhibitors as a class increase urinary zinc excretion and lower intracellular zinc over months of use. Zinc Picolinate is a... |
| Berberine | Caution | Losartan | Berberine can inhibit CYP2C9 activity and may alter losartan conversion to its active metabolite E-3174. Berberine may also lower blood... |
| Berberine HCl | Caution | Losartan | Berberine HCl can inhibit CYP2C9 activity and may alter losartan conversion to its active metabolite E-3174. Berberine HCl may also lower... |
| Lithium | Caution | Lisinopril | ACE inhibitors reduce renal lithium clearance, potentially increasing lithium levels by 25-40% and causing lithium toxicity. Symptoms... |
| Spironolactone | Caution | Lisinopril | Both ACE inhibitors and spironolactone increase serum potassium through different mechanisms. Combined use significantly increases the... |
| Fish Oil | Synergy | Lisinopril, Losartan, Ramipril | Lisinopril: Fish Oil reduces blood pressure modestly (about 3/1.5 mm Hg in hypertensives) and has independent renoprotective effects through... |
| Magnesium Citrate | Synergy | Lisinopril, Losartan | Lisinopril: Magnesium supplementation lowers blood pressure modestly, with meta-analyses reporting about 2-3 mm Hg systolic and 2 mm Hg diastolic... |
| Quercetin | Synergy | Lisinopril, Enalapril | Lisinopril: Quercetin lowers blood pressure modestly (about 5-7 mm Hg systolic in stage 1 hypertensives) through endothelial improvement, AT1 receptor... |
| Vitamin D3 | Synergy | Lisinopril, Losartan | Lisinopril: Vitamin D directly suppresses renin biosynthesis, so vitamin D deficiency leaves the renin-angiotensin system over-activated. Correcting... |
| Alpha-Lipoic Acid | Synergy | Lisinopril | Alpha-Lipoic Acid lowers blood pressure modestly and improves endothelial function. The QUALITY study found that the blood pressure and... |
| Grape Seed Extract | Synergy | Lisinopril | Grape Seed Extract lowers blood pressure modestly (about 6 mm Hg systolic and 3 mm Hg diastolic in meta-analyses) through improved... |
| L-Arginine | Synergy | Lisinopril | L-Arginine is the substrate for endothelial nitric oxide synthase, and oral supplementation produces modest blood pressure reductions... |
| Magnesium Taurate | Synergy | Lisinopril | Magnesium supplementation lowers blood pressure modestly, with meta-analyses reporting about 2-3 mm Hg systolic reductions in... |
| NAC | Synergy | Lisinopril | NAC has direct ACE-inhibitory activity (about 30% reduction in ACE activity in vivo) and provides sulfhydryl groups that may amplify... |
| Olive Leaf Extract | Synergy | Lisinopril | Olive Leaf Extract lowers blood pressure (about 4-11 mm Hg systolic depending on dose) and was non-inferior to captopril for stage 1... |
| Pine Bark Extract | Synergy | Ramipril | Pine Bark Extract (Pycnogenol) lowers blood pressure (about 3 mm Hg systolic and 3 mm Hg diastolic in a meta-analysis) and has independent... |
| Spirulina | Synergy | Lisinopril | Spirulina lowers blood pressure modestly in adults (about 3-5 mm Hg systolic and 3-4 mm Hg diastolic in meta-analyses). It also contains... |
| Taurine | Synergy | Lisinopril | Taurine lowers blood pressure in prehypertensive and hypertensive adults (about 7 mm Hg systolic in randomized trials) and reduces... |
What ACE inhibitors and ARBs can deplete.
Nutrients associated with long-term use somewhere in this class, worst documented severity first. Discuss any replacement with your prescriber.
| Nutrient | Severity | Documented for | Replace with | Monitor |
|---|---|---|---|---|
| Zinc | Moderate | Lisinopril, Losartan, Enalapril +9 more | Zinc Picolinate | Serum zinc |
| Sodium | Mild | Perindopril | – | Serum sodium |
Common ACE inhibitors and ARBs questions.
Quick answers drawn from the tables above.
What supplements should I avoid with ACE inhibitors and ARBs?
Across the class, 2 substance pairings are flagged to avoid or as a serious conflict, including Potassium and St. John's Wort. The exact risk depends on which medication in the class you take, so check your specific drug's page and confirm with your prescriber.
Do all ACE inhibitors and ARBs interact with supplements the same way?
No. Interactions are documented per drug, and the 14 ACE inhibitors and ARBs in the database differ in how they are absorbed and cleared. The class table above shows which members carry each record; a drug without a record is undocumented, not proven safe.
Do ACE inhibitors and ARBs deplete any nutrients?
Some medications in this class are documented to lower Zinc and Sodium with long-term use; the depletion table on this page shows which specific drugs carry each record. Useful biomarkers to monitor include Serum zinc and Serum sodium. Ask your prescriber before adding a replacement supplement.
Is it safe to take Potassium with ACE inhibitors and ARBs?
NutriStack classifies the Potassium and Losartan pairing as conflict: Losartan blocks angiotensin II type 1 receptors, reducing aldosterone secretion and thereby decreasing renal potassium excretion. Adding potassium supplementation on... The interaction is documented for 14 of the 14 ACE inhibitors and ARBs, and severity differs by drug. Always confirm with your prescriber.
Check your whole stack
See how your medication fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.