Generic Name: ramipril (RA-mi-pril)
Brand Name: Altace
Ramipril may cause injury or death to the fetus if taken after the third month of pregnancy. If you think you may be pregnant, contact your doctor right away.
Ramipril is used for:
Treating high blood pressure or decreasing the risk of heart attack, stroke, and death in certain patients. It may be used alone or with other medicines. It is used along with other medicines to manage heart failure and improve survival after a heart attack. It may also be used for other conditions as determined by your doctor.
Ramipril is an angiotensin-converting enzyme (ACE) inhibitor. It works by relaxing blood vessels. This helps to lower blood pressure.
Do NOT use ramipril if:
- you are allergic to any ingredient in ramipril or to another ACE inhibitor (eg, lisinopril)
- you have a history of angioedema (swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness) caused by treatment with an ACE inhibitor
- you are in your second or third trimester of pregnancy
- you are taking telmisartan
Contact your doctor or health care provider right away if any of these apply to you.
Before using ramipril:
Some medical conditions may interact with ramipril. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are able to become pregnant
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a history of heart problems (eg, aortic stenosis, heart failure), blood vessel problems, blood flow problems, bone marrow problems, kidney problems (eg, renal artery stenosis), certain liver problems (eg, ascites, cirrhosis), or diabetes
- if you have a history of angioedema, a stroke, or a recent heart attack, or you have had a kidney transplant
- if you have an autoimmune disease (eg, lupus, rheumatoid arthritis, scleroderma)
- if you are dehydrated or have low blood volume, high blood potassium levels, or low blood sodium levels, or if you are on a low-salt (sodium) diet
- if you are receiving treatments to reduce sensitivity to bee stings
- if you are on dialysis or are scheduled to have surgery or undergo anesthesia
Some MEDICINES MAY INTERACT with ramipril. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Diuretics (eg, furosemide, hydrochlorothiazide) because the risk of low blood pressure may be increased
- Aldosterone blockers (eg, eplerenone), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), potassium-sparing diuretics (eg, spironolactone, triamterene), potassium supplements, or trimethoprim because the risk of high blood potassium levels may be increased
- Telmisartan because the risk of kidney problems may be increased
- Certain gold-containing medicines (eg, sodium aurothiomalate) because flushing, nausea, vomiting, and low blood pressure may occur
- Lithium or thiopurines (eg, azathioprine) because the risk of their side effects may be increased by ramipril
This may not be a complete list of all interactions that may occur. Ask your health care provider if ramipril may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use ramipril:
Use ramipril as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take ramipril by mouth with or without food.
- Swallow this tablet whole unless your doctor tells you otherwise.
- Continue to take ramipril even if you feel well. Do not miss any doses.
- If you miss a dose of ramipril, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use ramipril.
Important safety information:
- Ramipril may cause dizziness, lightheadedness, or fainting. These effects may be worse if you take it with alcohol or certain medicines. Use ramipril with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Ramipril may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Ramipril may cause a serious side effect called angioedema. Contact your doctor at once if you develop swelling of the hands, face, lips, eyes, throat, or tongue; difficulty swallowing or breathing; or hoarseness.
- Ramipril may not work as well in black patients. They may also be at greater risk of side effects. Contact your doctor if your symptoms do not improve or if they become worse.
- Dehydration, excessive sweating, vomiting, or diarrhea may increase the risk of low blood pressure. Contact your health care provider at once if any of these occur.
- Rarely, ramipril may lower the ability of your body to fight infection. This risk may be greater if you have certain other health problems (eg, kidney problems, collagen vascular disease). Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
- Check with your doctor before you use a salt substitute or a product that has potassium in it.
- Tell your doctor or dentist that you take ramipril before you receive any medical or dental care, emergency care, or surgery.
- Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
- If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.
- Diabetes patients - Ramipril may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Lab tests, including blood pressure, blood electrolyte levels, heart function, or kidney or liver function, may be performed while you use ramipril. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use ramipril with caution in the ELDERLY; they may be more sensitive to its effects.
- Ramipril should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
- PREGNANCY AND BREAST-FEEDING: Ramipril may cause birth defects or fetal death if you take it while you are pregnant. If you think you may be pregnant, contact your doctor right away. It is not known if ramipril is found in breast milk. Do not breast-feed while taking ramipril.
Possible side effects of ramipril:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Cough; dizziness; headache; tiredness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the hands, eyes, mouth, face, lips, throat, or tongue; hoarseness); chest pain; dark urine; decreased urination; difficulty swallowing; infection (eg, fever, chills, persistent sore throat); irregular heartbeat; loss of appetite; pale stools; red, swollen, blistered, or peeling skin; seizures; stomach pain (with or without nausea or vomiting); symptoms of low blood pressure (eg, fainting, severe dizziness, lightheadedness); yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; severe dizziness or lightheadedness; weakness.Proper storage of ramipril:
Store ramipril between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep ramipril out of the reach of children and away from pets.
- If you have any questions about ramipril, please talk with your doctor, pharmacist, or other health care provider.
- Ramipril is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information is a summary only. It does not contain all information about ramipril. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.