Ramipril: Hypertension Uses, Side Effects & Dosage (original) (raw)
Generic Name: ramipril
Brand Name: Altace
Drug Class: ACE Inhibitors
What is ramipril, and what is it used for?
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.
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.
SLIDESHOW How to Lower Blood Pressure: Exercise and Tips See Slideshow
Pregnancy and 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).
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Summary
Ramipril 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. 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).
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Medically Reviewed on 3/31/2023
References
Medically reviewed by John P. Cunha, DO, FACOEP; Board Certified Emergency Medicine
REFERENCE:
FDA Prescribing Information