transderm-nitro and Altace Interactions

Interactions between transderm-nitro(nitroglycerin) and Altace (ramipril)

nitroglycerin and ramipril (Moderate Drug-Drug)

MONITOR: Angiotensin converting enzyme (ACE) inhibitors may enhance the vasodilatory and hypotensive effects of nitroglycerin. Data have also shown that captopril can prevent nitrate tolerance. ACE inhibitors can decrease systemic vascular resistance and cardiac work, further enhancing the effectiveness of nitroglycerin.

MANAGEMENT: In general, this combination is used to clinical advantage; however, some manufacturers recommend that nitrates and other vasodilators should be discontinued before starting ACE inhibitors or resumed at a reduced dose. Blood pressure monitoring is advisable.