Must angiotensin-converting enzyme (ACE) inhibitors be discontinued prior to dexamethasone suppression testing?

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Last updated: May 22, 2025View editorial policy

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From the Research

No, you do not need to stop taking your ACE inhibitor before undergoing dexamethasone suppression testing. ACE inhibitors like lisinopril, enalapril, or ramipril do not significantly interfere with the results of dexamethasone suppression tests, which are used to evaluate cortisol production and diagnose conditions like Cushing's syndrome. The dexamethasone suppression test measures how your body responds to dexamethasone, a synthetic glucocorticoid that should normally suppress cortisol production, while ACE inhibitors primarily affect the renin-angiotensin-aldosterone system rather than cortisol metabolism.

However, you should always inform your healthcare provider about all medications you are taking before any diagnostic test. Some other medications, particularly those containing steroids or certain antidepressants, can affect dexamethasone test results and may need to be temporarily discontinued. If you have concerns about potential interactions between your ACE inhibitor and the dexamethasone test, consult with your healthcare provider who can provide personalized advice based on your specific medical situation. The most recent study 1 focused on the interpretation of abnormal dexamethasone suppression test results, but it did not address the interaction between ACE inhibitors and the test.

Key points to consider:

  • ACE inhibitors do not significantly affect cortisol metabolism
  • Inform your healthcare provider about all medications before the test
  • Other medications, such as steroids or certain antidepressants, may need to be temporarily discontinued
  • Consult with your healthcare provider for personalized advice on potential interactions between your ACE inhibitor and the dexamethasone test, as seen in studies such as 2, 3, 4, and 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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