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What is ramipril?
Ramipril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Ramipril is used to treat high blood pressure (hypertension), heart failure, and to improve survival after a heart attack. Ramipril may also be used for purposes other than those listed in this medication guide.

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of ramipril?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• feeling light-headed, fainting;

• urinating more or less than usual, or not at all;

• fever, chills, body aches, flu symptoms;

• pale skin, easy bruising or bleeding;

• tired feeling, muscle weakness, and pounding or uneven heartbeats;

• chest pain; or

• swelling, rapid weight gain.

Less serious side effects may be more likely to occur, such as:

• cough;

• dizziness, drowsiness, headache;

• sleep problems (insomnia);

• decreased sex drive, impotence, or difficulty having an orgasm;

• nausea, vomiting; or

• mild skin itching or rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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How should I take ramipril?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Take each dose with a full glass of water. Ramipril can be taken with or without food. Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking ramipril. Drink plenty of water each day while you are taking this medication.

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What is the most important information I should know about ramipril?
Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Ramipril could cause birth defects in the baby if you take the medication during pregnancy. Use an effective form of birth control. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of ramipril. Do not use salt substitutes or potassium supplements while taking ramipril, unless your doctor has told you to.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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What other drugs will affect ramipril?
Before taking ramipril, tell your doctor if you are taking any of the following drugs: lithium (Lithobid, Eskalith); a potassium supplement such as K-Dur, Klor-Con; salt substitutes that contain potassium; aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others; or a diuretic (water pill). If you are using any of these drugs, you may not be able to use ramipril or you may need dosage adjustments or special tests during treatment.

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Ramipril has been assigned to pregnancy category D by the FDA for use during the second and third trimesters and to category C during the first trimester. Animal and human data have revealed evidence of embryolethality and teratogenicity associated with ACE inhibitors. There are no controlled data in human pregnancy. Congenital malformations have been reported with the use of ACE inhibitors during the first trimester of pregnancy, while fetal and neonatal toxicity, death, and congenital anomalies have been reported with the use of ACE inhibitors during the second and third trimesters of pregnancy. If the patient becomes pregnant, ramipril should be discontinued as soon as possible. Ramipril is considered contraindicated during pregnancy.

Drugs that act directly on the renin-angiotensin system can cause fetal and neonatal morbidity and death when administered during pregnancy. A committee of the National Institutes of Health has recommended that these drugs be avoided during pregnancy. Limited data have shown an association between major congenital malformations and the use of ACE inhibitors during the first trimester. In addition, the use of drugs that act directly on the renin-angiotensin system during the second and third trimesters of pregnancy has been associated with fetal and neonatal injury, including hypotension, neonatal skull hypoplasia, anuria, reversible or irreversible renal failure, and death. Oligohydramnios has also been reported, presumably resulting from decreased fetal limb contractures, craniofacial deformation, and hypoplastic lung development. Prematurity, intrauterine growth retardation, and patent ductus arteriosus have also been reported, although it is not clear whether these occurrences were due to exposure to the drug. Mothers whose embryos and fetuses are exposed to an ACE inhibitor during the first trimester should be informed of the risks. When pregnancy is detected or expected, ramipril should be discontinued as soon as possible.

There are no data on the excretion of ramipril into human milk. Animal data indicate that ramipril may appear in milk in concentrations of approximately one third that found in maternal plasma. Ingestion of a single 10 mg oral dose of ramipril resulted in undetectable amounts of ramipril and its metabolites in breast milk. However, because multiple doses may produce low milk concentrations that are not predictable from single doses, the manufacturer recommends that women receiving ramipril should not breast-feed.

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Who should NOT use this medication?

• Known hypersensitivity (e.g., history of angioedema) to ramipril or another ACE inhibitor.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a ramipril overdose may include feeling extremely dizzy or light-headed, or fainting.

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What should I discuss with my healthcare provider before taking ramipril?
Do not use this medication if you are allergic to ramipril or to any other ACE inhibitor, such as benazopril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), or trandolapril (Mavik). Before using ramipril, tell your doctor if you are allergic to any drugs, or if you have: kidney disease (or if you are on dialysis); liver disease; heart disease or congestive heart failure;

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Can I stop taking the medication if I feel better?
Even though you may feel better you should not stop taking your high blood pressure medication without first checking with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
More Information

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