ramipril at a glance
Medicine class
ACE inhibitor.
Available forms
Tablets, capsules and oral liquid.
Food
May be taken with or without food.
Routine checks
Blood pressure, kidney function and blood potassium require monitoring.
What is ramipril used for?
Ramipril products are licensed for:
High blood pressure.
Symptomatic heart failure.
Reducing cardiovascular illness and death in selected people with cardiovascular disease or diabetes.
Specified diabetic and non-diabetic kidney diseases involving albumin or protein in the urine.
Reducing mortality after an acute heart attack in clinically stable people with signs of heart failure.
How does ramipril work?
Ramipril is converted to ramiprilat, which blocks angiotensin-converting enzyme. This allows blood vessels to widen and reduces pressure on the heart and kidneys.
ramipril preparations and strengths
Capsule
Route: Oral
Strengths: 1.25 mg, 2.5 mg, 5 mg, 10 mg
Oral solution
Route: Oral
Strengths: 2.5 mg/5 mL, 5 mg/5 mL, 10 mg/5 mL
How to take ramipril
Follow the prescription label and instructions for your product.
Take with or without food.
Swallow tablets or capsules with water; do not chew or crush them.
Measure oral solution with the supplied device, not a kitchen teaspoon.
Check the product instructions because oral-solution storage after opening varies between manufacturers.
ramipril side effects
Common or expected effects
- Dry, persistent cough
- Dizziness or light-headedness
- Headache
- Diarrhoea, nausea or vomiting
- Mild skin rash
Get urgent medical advice
- Face, lip, tongue or throat swelling, or difficulty breathing or swallowing: stop ramipril and get urgent help.
- Very little or no urine, blood in the urine or marked swelling: seek prompt assessment.
- Yellow skin or eyes, severe abdominal pain, unusual bleeding, fever or recurrent infections: obtain urgent assessment.
- Blistering, peeling or another severe skin reaction: seek urgent help.
ramipril in pregnancy
Ramipril is not recommended during pregnancy and is contraindicated in the second and third trimesters because it can harm the fetus or newborn. Arrange a prescriber review when planning pregnancy. If pregnancy occurs, stop ramipril and contact the prescriber promptly.
ramipril while breastfeeding
Product information does not recommend ramipril during breastfeeding because evidence is limited. UK specialist advice says it may be used cautiously when clinically appropriate, although enalapril is preferred. Extra care is needed with newborn or premature babies. Seek advice if the infant has poor feeding, unusual sleepiness, pallor, inadequate weight gain or fewer wet nappies.
ramipril interactions
Tell the prescriber or pharmacist about all medicines, supplements and salt substitutes. Important examples include:
Sacubitril/valsartan
The combination is contraindicated because it substantially increases angioedema risk.
Potassium supplements, potassium salt substitutes and potassium-sparing diuretics
These may dangerously raise blood potassium.
NSAIDs such as ibuprofen or indometacin
These can reduce the blood-pressure effect and increase kidney impairment and high potassium risks.
Common questions about ramipril
Answers are fully visible for fast scanning and source review.
Can ramipril cause a dry cough?
Yes. Speak to the prescriber if it is troublesome; cough medicines usually do not resolve this type of cough.
Can swelling occur after years of taking ramipril safely?
Yes. Stop ramipril and seek urgent help for swelling of the face, lips, tongue or throat, or difficulty breathing or swallowing.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.