ramipril, Altace (cont.)

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Medical and Pharmacy Editor:

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 blood pressure in the arteries that supply blood to the kidneys. This reduces damage to the kidneys resulting from 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 C to 30 C (59 F to 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 for hypertension is 2.5-20 mg a day as a single dose or two divided doses. Patients taking diuretics or who have reduced kidney function may require lower doses. Heart failure is initially treated with 1.25-2.5 mg twice daily then titrated up to 10 mg once daily or 5 mg twice daily. The dose for preventing heart attacks and strokes is 2.5-10 mg daily.

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.

Medically Reviewed by a Doctor on 4/1/2013


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