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- What is ramipril, and how does it work (mechanism of action)?
- What brand names are available for ramipril?
- Is ramipril available as a generic drug?
- Do I need a prescription for ramipril?
- What are the side effects of ramipril?
- What is the dosage for ramipril?
- Is ramipril safe to take if I'm pregnant or breastfeeding?
- What else should I know about ramipril?
What is ramipril, and how does it work (mechanism of action)?
Ramipril belongs to a class of drugs called angiotensin converting enzyme (ACE) inhibitors that are used for treating high blood pressure, heart failure and for preventing kidney failure due to high blood pressure and diabetes. Other ACE inhibitors include 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 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.
What are the side effects of ramipril?
Ramipril generally is well-tolerated, and side effects usually are mild and transient.
Common side effects include a dry, persistent cough and increased potassium in the blood (hyperkalemia). Coughing resolves after discontinuing the drug.
Other important 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.
Quick GuideHow to Lower Blood Pressure: Exercise Tips
What is the dosage for ramipril?
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.
Is ramipril safe to take if I'm pregnant or breastfeeding?
ACE inhibitors, including ramipril, are harmful to the fetus and, therefore, should not be used during pregnancy.
Ramipril should not be administered to women who are breastfeeding.
What else should I know about ramipril?
What preparations of ramipril are available?
Capsules or tablets: 1.25, 2.5, 5 and 10 mg
How should I keep ramipril stored?
Tablets and capsules should be stored at room temperature between 15 C to 30 C (59 F to 86 F).
Summary
ramipril (Altace) is an ACE inhibitor drug prescribed for the treatment of congestive heart failure and high blood pressure. Altace also prevents heart attacks, strokes, and deaths due to heart disease in individuals at risk for these diseases. Side effects, multiple drug interactions, dosage, and pregnancy safety should be reviewed prior to taking this medication.
Multimedia: Slideshows, Images & Quizzes
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Picture of Hypertension
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Medications & Supplements
- quinapril, Accupril
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- benazepril (Lotensin HTC)
- fosinopril sodium, Monopril
- enalapril, Vasotec, Epaned
- lisinopril (Zestril, Prinivil, Qbrelis) ACE Inhibitor
- lisinopril and hydrochlorothiazide, Zestoretic, Prinzide
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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.
Top ramipril Related Articles
Congestive Heart Failure (CHF) Overview
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.Diabetes Mellitus
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.Heart Attack
Heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.Heart Attack and Atherosclerosis Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience:
- Extreme fatigue
- Pain in the upper abdomen
- Dizziness
- Fainting
Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
CAD Slideshow
What is heart disease (coronary artery disease)? Learn about the causes of heart disease. Symptoms of heart disease include chest pain and shortness of breath. Explore heart disease diagnosis, treatment, and prevention.Heart Disease Slideshow
Learn about heart disease and heart attack symptoms and signs of a heart attack in men and women. Read about heart disease diagnostic tests, treatments, and prevention strategies.Heart Failure
Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include
- congested lungs,
- fluid and water retention,
- dizziness,
- fatigue and weakness, and
- rapid or irregular heartbeats.
There are two types of congestive heart failure, systolic or left-sided heart failure; and diastolic or right-sided heart failure. Treatment, prognosis, and life-expectancy for a person with congestive heart failure depends upon the stage of the disease.
High Blood Pressure Hypertension
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms.
Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure.
The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater.
If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.
REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Hypertension Picture
High blood pressure, defined as a repeatedly elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above 140 with a diastolic pressure above 90. See a picture of Hypertension and learn more about the health topic.Kidney Failure
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, or medication. Some of the renal causes of kidney failure include sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis.
Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones.Treatment options included diet, medications, or dialysis.
Parathyroidectomy
Parathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
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- damage to the recurrent laryngeal nerve,
- bleeding or hematoma,
- problems maintaining calcium levels in the blood,
- need for further and more aggressive surgery,
- need for a limited or total thyroidectomy,
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Pregnancy Drug Dangers
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.Stroke Symptoms and Treatment
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic).
Symptoms of a stroke may include:
- weakness,
- numbness,
- double vision or vision loss,
- confusion,
- vertigo,
- difficulty speaking or understanding speech.
A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
