Ramipril

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Ramiwin, Rampil, Tritace

Popular combinations:

Tri-Plen, Tritace plus

Drug group:

ACE inhibitor, drug for hypertension

Prescription needed?

Yes

What does it do?

Ramipril is mainly used to treat hypertension (high blood pressure), but is also used to:

• Reduce strain on the heart in patients with heart failure (eg after a heart attack)
• Prevent future strokes and heart attacks in patients with cardiovascular disease
• Preserve kidney function in conditions such as diabetes mellitus

How does it work?

Ramipril is an ACE inhibitor - it reduces vasoconstriction, which means that the blood vessels relax, making it easier for the heart to pump blood.

How should it be used?

• The first dose of an ACE inhibitor can cause blood pressure to drop suddenly, so it is advisable to take this first dose when you can lie down for a while
• Reducing your salt intake and exercising regularly can help control your blood pressure

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

25–10mg daily, 1–2 x daily depending on condition being treated

How quickly will it start to work?

Within 2 hours; full beneficial effect may take several weeks   
    

How long will the effects last?

Up to 24 hours    
 

When should I stop using it?

Do not stop taking the drug without consulting your doctor        
                            

Is it safe for prolonged use?

No problems expected, but regular monitoring of potassium levels, white blood cell count, kidney function, and urine are usually required.                                

What are the possible side effects?

Most side effects are mild and transient. The following have been reported:

• More common: mild rash, dry cough
• Less common: mouth ulcers, a sore mouth, dizziness, sore throat, fever
• Rare: deterioration of kidney function, digestive tract disturbances, a severe rash
• Report to your doctor before taking your next dose if you experience: swelling of the mouth/lips, breathing difficulties

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney/heart problems, previous angioedema or allergic reaction to ACE inhibitors, current/planned pregnancy
• Other medicines: Non-steroidal anti-inflammatory drugs (NSAIDs), potassium supplements, potassium-sparing diuretics, ciclosporin, lithium, vasodilators, other antihypertensives
• Pregnancy and breast-feeding: Not prescribed in pregnancy as it may harm the foetus, safety in breastfeeding not established
• Children: Not recommended
• Over 60: Reduced dose may be necessary
• Driving and hazardous work: Caution, the drug can cause dizziness and fainting
• Alcohol: Avoid, enhanced blood-pressure-lowering and adverse effects
• Surgery and general anaesthetics: Ramipril may need to be stopped before surgery