ramipril, Altace (cont.)

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Medical and Pharmacy Editor:

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.

Combining ramipril or other ACE inhibitors with NSAIDs in patients who are elderly, volume-depleted (including those on diuretic therapy), or with poor kidney function may result in reduced kidney function, including kidney failure. These effects usually are reversible.

Nitritoid reactions (symptoms include facial flushing, nausea, vomiting and low blood pressure [hypotension]) may occur when injectable gold (sodium aurothiomalate), used in the treatment of rheumatoid arthritis, is combined with ACE inhibitors, including ramipril.

PREGNANCY: ACE inhibitors, including ramipril, are harmful to the fetus and, therefore, should not be used during pregnancy.

NURSING MOTHERS: Ramipril should not be administered to women who are breastfeeding.

SIDE EFFECTS: Ramipril generally is well-tolerated, and side effects usually are mild and transient. A dry, persistent cough has been reported with the use of ramipril and other ACE inhibitors. Coughing resolves after discontinuing the drug. Other side effects include abdominal pain, constipation, diarrhea, rash, dizziness, fatigue, headache, loss of taste, loss of appetite, nausea, vomiting, fainting and numbness or tingling in the hands or feet.

Medically Reviewed by a Doctor on 4/1/2013


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