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Ramipril Side Effects

In Summary

Commonly reported side effects of ramipril include: hypotension and increased cough. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to ramipril: oral capsule, oral tablet

Along with its needed effects, ramipril may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ramipril:

More common
  • Blurred vision
  • confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • sweating
  • unusual tiredness or weakness
Less common
  • Arm, back, or jaw pain
  • chest pain or discomfort
  • chest tightness or heaviness
  • chills
  • cloudy urine
  • cold sweats
  • decrease in urine output or decrease in urine-concentrating ability
  • diarrhea
  • fainting
  • fast or irregular heartbeat
  • shortness of breath
  • Seizures
  • unexplained bleeding or bruising

Some side effects of ramipril may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Cough
Less common Rare
  • Feeling of constant movement of self or surroundings
  • muscle pain or stiffness
  • sensation of spinning
  • stomach pain
  • weight loss

For Healthcare Professionals

Applies to ramipril: oral capsule, oral tablet


The most common adverse reaction is hypotension.[Ref]


Very common (10% or more): Hypotension (11%)
Common (1% to 10%): Angina pectoris, postural hypotension, orthostatic blood pressure decreased
Uncommon (0.1% to 1%): Symptomatic hypotension, myocardial ischemia, myocardial infarction, tachycardia, arrhythmia, palpitation, flushing
Rare (less than 0.1%): Vascular stenosis, hypoperfusion, vasculitis
Frequency not reported: Disturbed orthostatic regulation, Raynaud's phenomenon[Ref]


Common (1% to 10%): Nausea, vomiting, diarrhea, gastrointestinal inflammation, digestive disturbances, abdominal discomfort, dyspepsia
Uncommon (0.1% to 1%): Pancreatitis, pancreatic enzymes increased, abdominal pain, small bowel angioedema, gastritis, constipation, dry mouth
Rare (less than 0.1%): Glossitis
Frequency not reported: Dysphagia, gastroenteritis, increased salivation, gastric pain, aphthous stomatitis[Ref]


Common (1% to 10%): Fatigue, asthenia, vertigo, bronchitis, sinusitis, chest pain
Uncommon (0.1% to 1%): Peripheral edema, pyrexia, libido decreased
Rare (less than 0.1%): Conjunctivitis, hearing impaired, tinnitus
Frequency not reported: Hearing loss, edema, malaise, gynecomastia[Ref]


Common (1% to 10%): Cough, nonproductive tickling cough, cough increased, dyspnea
Uncommon (0.1% to 1%): Bronchospasm, asthma aggravated
Frequency not reported: Eosinophilic pneumonitis, epistaxis, nasal congestion[Ref]


Uncommon (0.1% to 1%): Depressed mood, anxiety, nervousness, restlessness, sleep disorder
Rare (less than 0.1%): Confusional state
Frequency not reported: Depression, insomnia, disturbance in attention[Ref]

Nervous system

Common (1% to 10%): Headache, dizziness, syncope
Uncommon (0.1% to 1%): Paresthesia, dysgeusia, ageusia, somnolence
Rare (less than 0.1%): Tremor, balance disorder
Frequency not reported: Smell disturbance, amnesia, convulsions, neuralgia, neuropathy, cerebral ischemia, ischemic stroke, transient ischemic attack, psychomotor skills impaired, burning sensation, parosmia[Ref]


Common (1% to 10%): Muscle spasm, myalgia
Uncommon (0.1% to 1%): Arthralgia
Frequency not reported: Arthritis[Ref]


Common (1% to 10%): Maculopapular rash
Uncommon (0.1% to 1%): Pruritus, hyperhidrosis
Rare (less than 0.1%): Exfoliative dermatitis, urticaria, onycholysis
Frequency not reported: Purpura, pemphigus, pemphigoid, erythema multiforme, toxic epidermal necrolysis, Stevens Johnson syndrome, sweating increased, alopecia, psoriasis aggravated, dermatitis psoriasiform, lichenoid exanthema, enanthema[Ref]


Common (1% to 10%): Abnormal kidney function
Uncommon (0.1% to 1%): Renal impairment, acute renal failure[Ref]


Common (1% to 10%): Creatinine increased, blood potassium increased
Uncommon (0.1% to 1%): Anorexia, decreased appetite, BUN increased
Frequency not reported: Weight gain, hyponatremia, loss of appetite, uric acid elevated, blood glucose elevated, blood sodium decreased
Postmarketing reports: Hypoglycemia[Ref]


Uncommon (0.1% to 1%): Worsening of preexisting proteinuria, urine output increased, transient erectile impotence
Frequency not reported: Proteinuria, impotence[Ref]


Uncommon (0.1% to 1%): Visual disturbance, blurred vision[Ref]


Uncommon (0.1% to 1%): Eosinophilia, hemoglobin or hematocrit decreased
Rare (less than 0.1%): Neutropenia, agranulocytosis, white blood cell count decreased, red blood cell count decreased, platelet count decreased
Frequency not reported: Pancytopenia, hemolytic anemia, thrombocytopenia, leucopenia, bone marrow failure[Ref]


Uncommon (0.1% to 1%): Hepatic enzymes increased, conjugated bilirubin increased
Rare (less than 0.1%): Cholestatic jaundice, hepatocellular damage
Frequency not reported: Hepatic failure, hepatitis, jaundice, acute liver failure, hepatocellular damage, cholestatic hepatitis, cytolytic hepatitis, serum bilirubin elevated[Ref]


Uncommon (0.1% to 1%): Angioneurotic edema, angioedema
Very rare (less than 0.01%): Photosensitivity
Frequency not reported: Anaphylactic reaction, anaphylactoid reaction, apparent hypersensitivity reaction, antinuclear antibody increased[Ref]


Frequency not reported: Syndrome of inappropriate antidiuretic hormone secretion[Ref]


1. Cerner Multum, Inc. "Australian Product Information." O 0

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.

Some side effects of ramipril may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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