Uses
What is ramipril used for?
Ramipril is commonly used for the following conditions.
- To lower high blood pressure (hypertension)
- To lower the risk for heart attack, stroke, or death in people with heart disease
- To lower the risk of death and hospitalization in people whose heart is not pumping blood as well as it should after a heart attack
Ramipril may also be used for other conditions as determined by your healthcare provider.
How does ramipril work (mechanism of action)?
Ramipril blocks the angiotensin-converting enzyme (ACE) from forming a hormone called angiotensin II. When angiotensin II binds to receptors, it causes your blood vessels to constrict. Blocking the formation of angiotensin II helps your blood vessels relax so that blood can move through them more easily. These effects can help your heart work better, lower blood pressure, and may reduce your risk for heart attack and stroke.
How is ramipril supplied (dosage forms)?
Ramipril is available as Altace and generic ramipril in the following dosage forms that are taken by mouth.
- 1.25 mg oral capsules
- 2.5 mg oral capsules
- 5 mg oral capsules
- 10 mg oral capsules
How should I store ramipril?
Ramipril should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of ramipril?
The most common side effects of ramipril are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Headache
- Dizziness
- Tiredness
- Cough
There may be other side effects of ramipril that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of ramipril?
While less common, the most serious side effects of ramipril are described below, along with what to do if they happen.
Angioedema. Ramipril may cause a rare reaction called angioedema. The usual symptoms of this reaction include swelling of the lips, face, tongue, or throat. Stop using the medicine and contact your healthcare provider if you have this type of swelling. If you are having trouble breathing, get medical attention right away.
Low Blood Pressure (Hypotension). Ramipril may cause low blood pressure. Low blood pressure is more likely to occur if you have excessive sweating or persistent or severe vomiting or diarrhea. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.
- Dizziness, feeling lightheaded, or fainting
- Confusion
- Feeling weak or tired
Kidney Damage. Kidney damage can happen when taking ramipril. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.
- Reduced need to pee
- Swelling in your feet, ankles, or legs
- Weakness or unusual tiredness
- Difficulty catching your breath or chest pain/pressure
- Confusion
- Nausea
- Seizures
High Potassium Level (Hyperkalemia). Ramipril can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your healthcare provider will check your potassium levels, especially if you take certain other medicines. Call your healthcare provider if you have any of the following symptoms of a high potassium level.
- Muscle weakness or unusual tiredness
- Slow heartbeat or feeling of skipped heartbeats
- Nausea or vomiting
- Trouble breathing
- Abnormal heart rhythm
Low Neutrophil Levels (Neutropenia). Ramipril may cause low levels of a type of white blood cell (called neutrophils), which is known as neutropenia. Neutrophils help prevent infection. Having a low level of neutrophils may increase your risk of infection. Tell your healthcare provider if you have any of the following symptoms of low neutrophil levels.
- Fever, chills, or sweats
- Tiredness
- Sore throat, cough, or shortness of breath
- Mouth or throat sores
Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking ramipril. Call your healthcare provider right away if you have any of the following symptoms of liver damage.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored urine
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Severe Allergic Reactions. Ramipril may cause allergic reactions, which can be serious. Stop using ramipril and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Warnings & Precautions
Who should not use ramipril?
Allergies to Ingredients. People who are allergic to any of the following should not take ramipril.
- Altace
- Ramipril
- Any other medicine known as an ACE inhibitor
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific ramipril products they stock.
History of Angioedema. Ramipril may cause a rare reaction called angioedema, where there is swelling under the skin. This medicine should not be used if you have had angioedema.
Drug Interactions. Ramipril should not be taken while you are using certain other medicines. Before taking ramipril, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
What should I know about ramipril before using it?
Do not take ramipril unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share ramipril with other people, even if they have the same condition as you. It may harm them.
Keep ramipril out of the reach of children.
Ramipril can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how ramipril affects you.
What should I tell my healthcare provider before using ramipril?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if ramipril is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Heart problems
- Kidney problems
- Liver problems
- Diabetes
- Electrolyte imbalance, such as high or low levels of sodium or potassium
- Persistent or severe vomiting or diarrhea
Pregnancy. Ramipril can cause death or serious harm to an unborn baby if taken during pregnancy. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant, stop taking ramipril right away and contact your healthcare provider.
Breastfeeding. It is not known if ramipril passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop ramipril.
Interactions
Does ramipril interact with foods or drinks?
There are no known interactions between ramipril and foods or drinks.
It is unknown if drinking alcohol will affect ramipril. The risk of dizziness may be increased if you drink alcohol while taking ramipril.
Does ramipril interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking ramipril.
- Aliskiren (Tekturna), which is a medicine for high blood pressure
- Entresto (sacubitril/valsartan), which is a medicine for heart failure
- A supplement or salt-substitute containing potassium
- A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
- A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
- Lithium, which is a medicine for certain mental health conditions
- An angiotensin-converting enzyme (ACE) inhibitor, which is a medicine for high blood pressure, heart failure, and certain kidney problems
- An angiotensin II receptor blocker (ARB), which is a medicine for high blood pressure, heart failure, and other heart conditions
- A medicine such as everolimus (Afinitor, Zortress), sirolimus (Rapamune and others), or temsirolimus (Torisel), which is commonly used to treat cancer or after an organ transplant
- Any medicine for high blood pressure
- This may not be a complete list of medicines that can interact with ramipril. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much ramipril?
If you or someone else has used too much ramipril, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of ramipril?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Are you currently using Ramipril (Altace)?
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