Ramipril: Considerations, Side Effects, Interactions, and Contraindications
Ramipril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure, heart failure, and to reduce the risk of heart attack, stroke, or death in patients more than 55 years old with a high risk of atherosclerotic disease and major adverse cardiac events1
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Considerations
- Ramipril is generally safe to take for a long time, but taking it for a long time can sometimes cause side effects.4
- Ramipril is a type of medicine called an ACE inhibitor. Like other ACE inhibitors, ramipril relaxes and widens your blood vessels. This lowers your blood pressure and makes it easier for your heart to pump blood around your body.4
- Ramipril starts to work within a few hours to reduce high blood pressure, but it may take a few weeks for full effect.4
- If you're taking ramipril for heart failure, it may take weeks, even months, before you feel better.4
Side Effects
Like all medicines, ramipril can cause side effects in some people, but many people have no side effects or only minor ones. Side effects often improve as your body gets used to the medicine5
- A dry, tickly cough that does not get better.5
- Feeling dizzy or lightheaded, especially when you stand up or sit up quickly.5
- Headaches.5
- Diarrhoea.5
- Being sick (vomiting) .5
- A mild skin rash.5
- Blurred vision.5
- Confusion.6
- Sweating.6
- Unusual tiredness or weakness.6
- Allergic reaction: You may have swelling (angioedema) of your face, arms, legs, lips, tongue, windpipe, and stomach. Tell your doctor right away if you have swelling in these areas or have stomach pain. Don't take any more ramipril until you talk to your doctor.7
- Birth defects: Ramipril may cause birth defects or be fatal to your unborn baby. Tell your doctor if you are planning to get pregnant or are pregnant.7
- Sudden swelling: Ramipril may cause sudden swelling of your face, arms, legs, lips, tongue, throat, and intestines. Stop taking ramipril and tell your doctor right away if you have swelling in these areas or have stomach pain.7
Interactions
There are some medicines that may affect the way ramipril works. Tell your doctor if you're taking any of these medicines:- Anti-inflammatory medicines such as ibuprofen, indomethacin, or aspirin for pain relief (low-dose aspirin – 75mg a day, is safe to take with ramipril) .8
- Medicines to treat low blood pressure, heart failure, asthma, or allergies, such as ephedrine, noradrenaline, or adrenaline.8
- Medicines for high blood pressure, such as aliskiren.9
- Medicines that can increase the amount of potassium in your blood, such as spironolactone, triamterene, amiloride, potassium supplements, trimethoprim (for infections), or heparin (for preventing blood clots) .8
- Steroid medicines such as prednisolone.8
- Allopurinol, for gout.8
- Procainamide, for heart rhythm problems.8
- Medicines for diabetes.8
- Lithium, for mental health problems.8
Contraindications
Ramipril is contraindicated in patients who are hypersensitive to this product or any other ACE inhibitor (e.g., a patient who has experienced angioedema during therapy with any other ACE inhibitor)9
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