The frequency of adverse reactions in hypertensive subjects was 34% with imidapril versus 36% with placebo.
The most common effects in the imidapril group were: cough, dizziness, fatigue/drowsiness, dyspepsia, and vomiting.
The unwanted effects observed during treatment with imidapril or other ACE inhibitors are as follows.
Investigations (biological abnormalities):
Decreases in hemoglobin, hematocrit, platelet, and leukocyte counts, as well as increases in liver enzymes, bilirubinemia, and creatine phosphokinase (CPK) levels have been reported in some patients. As imidapril decreases aldosterone secretion, an increase in serum potassium is possible. An increase in the level of urea in the blood and in serum creatinemia, reversible after stopping treatment, have been observed, particularly in the case of renal failure.
Cardiac disorders:
Severe hypotension is possible at the start of treatment or after increasing the dose, in certain risk groups. Hypotension may be accompanied by symptoms such as dizziness, a feeling of weakness, visual disturbances, and, rarely, disorders of consciousness (syncope). There have been some reports of tachycardia, palpitations, arrhythmia, angina, myocardial infarction, transient ischemic attack, and cerebral hemorrhage during hypotension while receiving ACE therapy.
Blood and lymphatic system:
Agranulocytosis, thrombocytopenia, pancytopenia, and anemia have been reported rarely in patients treated with ACE inhibitors. Some cases of hemolytic anemia under treatment with other ACE inhibitors have been reported in patients with congenital G-6-PD deficiency.
Nervous system disorders:
Dizziness, tiredness, and weakness have sometimes been reported. In rare cases, depression, sleep disturbances, paraesthesia, impotence, balance disturbances, mental confusion, tinnitus, blurred vision, headache, and taste abnormalities may be seen.
Respiratory, thoracic, and mediastinal disorders:
ACE inhibitors have been shown to cause cough quite frequently. In rare cases, dyspnea, sinusitis, rhinitis, glossitis, bronchitis, bronchospasm, or angioedema (angioedema) of the upper respiratory tract and very rare cases of alveolitis / allergic pneumonia may be observed. eosinophils have been reported.
Gastrointestinal disorders:
Diarrhea and nausea have been reported occasionally. In rare cases, vomiting, gastritis, abdominal pain, constipation, dry mouth, cholestatic jaundice, hepatitis, pancreatitis, and ileus may be observed.
Intestinal angioedema has been reported rarely with symptoms of abdominal pain with or without nausea or vomiting.
Renal and urinals:
In rare cases, kidney failure can occur or worsen. Acute kidney failure has been described with treatment with other ACE inhibitors.
Skin and subcutaneous tissue disorders:
In rare cases, allergy and hypersensitivity reactions such as rash, itching, rash, and urticaria have been reported. Undertreatment with ACE inhibitors, cases of erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrosis, psoriatic efflorescence, and alopecia have been reported. Skin signs may be accompanied by fever, myalgia, arthralgia, eosinophilia, and/or elevated levels of antinuclear antibodies. Like other ACE inhibitors, imidapril can induce angioedema (angioedema) that affects the face and oropharyngeal tissues.
Hepatobiliary disorders:
Patients treated with ACE inhibitors have developed jaundice or marked increases in liver enzymes.