Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: ramipril
BRAND NAME: Altace
DRUG CLASS AND MECHANISM: Ramipril belongs in a class of drugs called
angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors are used for
treating high blood pressure, heart failure and for preventing kidney failure
due to high blood pressure and diabetes. Other ACE inhibitors are enalapril
(Vasotec), quinapril (Accupril), captopril (Capoten),
fosinopril (Monopril),
benazepril (Lotensin), lisinopril (Zestril, Prinivil),
moexipril (Univasc) and
trandolapril (Mavik).
ACE is important because it is an enzyme responsible for
producing the chemical, angiotensin II. Angiotensin II causes muscles in most
arteries, including the arteries of the heart, to contract, thereby narrowing
the arteries and elevating blood pressure. ACE inhibitors such as ramipril
lower blood pressure by reducing the production of angiotensin II, thereby
relaxing arterial muscle and enlarging arteries. When the blood pressure is
lower, the heart - including the failing heart - does not have to work as hard to
pump blood. The arteries supplying the heart with blood also enlarge during
treatment with ACE inhibitors. This increases the flow of blood and oxygen to
the heart, further improving the ability of the heart to pump blood.
The effects
of ACE inhibitors are particularly beneficial to people with congestive heart
failure. In the kidneys, the narrowing of the arteries by angiotensin II
decreases blood flow. ACE inhibitors enlarge and reduce the blood pressure in
the arteries going to the kidney. This reduces damage to the kidneys caused by
high blood pressure. The FDA approved ramipril in 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules or tablets: 1.25, 2.5, 5 and 10 mg
STORAGE: Tablets and capsules should be stored at room temperature
between 15-30 C (59-86 F).
PRESCRIBED FOR: Ramipril is used for the treatment of congestive heart
failure (CHF) and hypertension (high blood pressure). Ramipril also prevents
heart attacks, strokes and deaths due to heart disease in patients who have risk
factors for such events. After a heart attack, ramipril reduces progression to
severe or resistant heart failure, hospitalization related to heart failure, and
heart disease-related death. Like other ACE inhibitors, ramipril may slow the
progression of kidney failure in patients with hypertension or diabetes by
reducing the damage to the kidneys caused by high blood pressure.
DOSING: The usual dose of ramipril is 2.5-20 mg a day as a single dose
or two divided doses. Patients taking diuretics or who have renal artery
stenosis (narrowing of the arteries going to the kidney) may require lower
doses.
DRUG INTERACTIONS: The use of ACE inhibitors with potassium
supplements, salt substitutes or diuretics [for example, spironolactone
(Aldactone) that
increase potassium in the blood may lead to excessive potassium levels.
Potassium levels should be monitored whenever ACE inhibitors are used in
combination with these drugs.
There have been reports of increased lithium
(Eskalith, Lithobid) levels when lithium is used in combination with ACE inhibitors. The
reason for this interaction is not known.
There have been reports that aspirin
and other nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen
(Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever etc),
indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- ACE Inhibitors - Read about ACE inhibitors like Altace, lisinopril, enalapril, ramparil, Zestril and more. Information includes side effects, drug interactions, and pregnancy safety information.
- Kidney Failure - Learn about kidney failure, in which the body has fluid retention, risen blood pressure, toxin build up and lack of red blood cells. Symptoms include fatigue, nausea, and apetite loss.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
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