Ramipril (By mouth)

Introduction

Ramipril (RA-mi-pril)

Treats high blood pressure and heart failure after a heart attack. Reduces risk of heart attack, stroke, and death in people 55 years and older who have heart disease. This medicine is an ACE (angiotensin-converting enzyme) inhibitor.

Brand Name(s)

Altace

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to ramipril or to any other ACE inhibitor (such as captopril, enalapril, lisinopril, Accupril®, Lotrel®, or Zestril®), or if you have a history of angioedema caused by an ACE inhibitor. Do not use this medicine if you are pregnant or breastfeeding.

How to Use This Medicine

Capsule, Tablet

  • Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
  • Swallow the capsule or tablet whole. If you cannot swallow the capsule, you may open it and pour the medicine into 4 ounces (½ cup) of applesauce, water, or apple juice. Consume this mixture all at once so you get all of the medicine.
  • Carefully follow your doctor's instructions about any special diet.Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Any medicine that has been mixed with apple juice or applesauce should be stored in the refrigerator and must be used within 48 hours.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are using other medicine for high blood pressure (such as atenolol, lisinopril, metoprolol, quinapril, telmisartan, timolol, Accupril®, Micardis®, or Toprol®) or a diuretic or water pill (such as amiloride, furosemide, hydrochlorothiazide [HCTZ], spironolactone, torsemide, triamterene, Aldactone®, Demadex®, Lasix®, or Zaroxolyn®).
  • Make sure your doctor knows if you also use lithium (Eskalith®, Lithobid®), gold injections (such as sodium aurothiomalate), pain or arthritis medicine (such as aspirin, celecoxib, diclofenac, etodolac, ibuprofen, indomethacin, naproxen, piroxicam, rofecoxib, valdecoxib, Advil®, Aleve®, Bextra®, Celebrex®, Ecotrin®, Feldene®, Motrin®, Relafen®, Vioxx®, or Voltaren®), or any diabetes medicine that you take by mouth.
  • Ask your doctor before you use medicines, supplements, or salt substitutes that contain potassium.

Warnings While Using This Medicine

  • Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
  • Make sure your doctor knows if you have kidney problems, liver disease, congestive heart failure, heart or blood vessel disease, diabetes, low blood pressure, or a mineral imbalance (high potassium or low sodium in the blood). Tell your doctor if you have a collagen vascular disease such as lupus or scleroderma.
  • Stop using this medicine and call your doctor right away if you have severe stomach pain (with or without nausea or vomiting). This could be a symptom of a serious allergic reaction.
  • This medicine could lower your blood pressure too much and cause you to feel dizzy or lightheaded. This is more likely to happen when you begin to use the medicine. It could also happen if you have diarrhea or vomiting, you sweat heavily, or you do not drink enough water and become dehydrated. If you faint, stop using this medicine until you have talked to your doctor.
  • Check with your doctor if you notice any signs of fever, chills, or sore throat. These could be symptoms of an infection caused by low white blood cell counts.
  • Stop using this medicine and check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
  • Hyperkalemia (high potassium in the blood) could occur. Check with your doctor right away if you have confusion, weakness, difficulty breathing, irregular heartbeat, or numbness or tingling in the hands, feet, or lips.
  • Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
  • Allergic reactions, including angioedema, are rare, but are more common among black patients.
  • This medicine may be less effective in black patients.
  • Even if you feel well, do not stop using the medicine without asking your doctor. This medicine will not cure your high blood pressure, but it will help keep it in normal range. You may have to take blood pressure medicine for the rest of your life.
  • Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blistering, peeling, or red skin rash
  • Change in how much or how often you urinate
  • Chest pain
  • Confusion, body weakness, uneven heartbeat, shortness of breath, or numbness or tingling in your hands, feet, or lips
  • Dark-colored urine or pale stools
  • Fever, chills, sore throat, and body aches
  • Lightheadedness, dizziness, or fainting
  • Nausea, vomiting, loss of appetite, or pain in your upper stomach
  • Severe stomach pain (with or without nausea or vomiting)
  • Swelling in your hands, ankles, or feet
  • Yellowing of your skin or the whites of your eyes

If you notice these less serious side effects, talk with your doctor:

  • Dry cough

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: June 18, 2013

         
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