Ramipril Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 26, 2023.

Applies to ramipril: oral capsule.

Important warnings This medicine can cause some serious health issues

Oral route (capsule; tablet)

When pregnancy is detected, discontinue ramipril as soon as possible.

Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Serious side effects of ramipril

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

Rare

• seizures
• unexplained bleeding or bruising

Other side effects of ramipril

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

• nausea
• vomiting

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.

General

The most common adverse reaction is hypotension.^[Ref]

Cardiovascular

• 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]

Gastrointestinal

• 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]

Other

• 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]

Respiratory

• 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]

Psychiatric

• 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]

Musculoskeletal

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

Dermatologic

• 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]

Renal

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

Metabolic

• 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]

Genitourinary

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

Ocular

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

Hematologic

• 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]

Hepatic

• 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]

Immunologic

• 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]

Endocrine

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

Frequently asked questions

• Do ACE inhibitors make COVID-19 worse?

Further information

Ramipril side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer