Ramipril Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 26, 2023.

Applies to ramipril: oral capsule.

Warning

Oral route (Capsule; Tablet)

When pregnancy is detected, discontinue ramipril as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Serious side effects of Ramipril

Along with its needed effects, ramipril may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ramipril:

More common

Blurred vision
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
sweating
unusual tiredness or weakness

Less common

Arm, back, or jaw pain
chest pain or discomfort
chest tightness or heaviness
chills
cloudy urine
cold sweats
decrease in urine output or decrease in urine-concentrating ability
diarrhea
fainting
fast or irregular heartbeat
shortness of breath

Rare

Seizures
unexplained bleeding or bruising

Other side effects of Ramipril

Some side effects of ramipril may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Cough

Less common

Nausea
vomiting

Rare

Feeling of constant movement of self or surroundings
muscle pain or stiffness
sensation of spinning
stomach pain
weight loss

For Healthcare Professionals

Applies to ramipril: oral capsule, oral tablet.

General

The most common adverse reaction is hypotension.^[Ref]

Cardiovascular

Very common (10% or more): Hypotension (11%)

Common (1% to 10%): Angina pectoris, postural hypotension, orthostatic blood pressure decreased

Uncommon (0.1% to 1%): Symptomatic hypotension, myocardial ischemia, myocardial infarction, tachycardia, arrhythmia, palpitation, flushing

Rare (less than 0.1%): Vascular stenosis, hypoperfusion, vasculitis

Frequency not reported: Disturbed orthostatic regulation, Raynaud's phenomenon^[Ref]

Gastrointestinal

Common (1% to 10%): Nausea, vomiting, diarrhea, gastrointestinal inflammation, digestive disturbances, abdominal discomfort, dyspepsia

Uncommon (0.1% to 1%): Pancreatitis, pancreatic enzymes increased, abdominal pain, small bowel angioedema, gastritis, constipation, dry mouth

Rare (less than 0.1%): Glossitis

Frequency not reported: Dysphagia, gastroenteritis, increased salivation, gastric pain, aphthous stomatitis^[Ref]

Other

Common (1% to 10%): Fatigue, asthenia, vertigo, bronchitis, sinusitis, chest pain

Uncommon (0.1% to 1%): Peripheral edema, pyrexia, libido decreased

Rare (less than 0.1%): Conjunctivitis, hearing impaired, tinnitus

Frequency not reported: Hearing loss, edema, malaise, gynecomastia^[Ref]

Respiratory

Common (1% to 10%): Cough, nonproductive tickling cough, cough increased, dyspnea

Uncommon (0.1% to 1%): Bronchospasm, asthma aggravated

Frequency not reported: Eosinophilic pneumonitis, epistaxis, nasal congestion^[Ref]

Psychiatric

Uncommon (0.1% to 1%): Depressed mood, anxiety, nervousness, restlessness, sleep disorder

Rare (less than 0.1%): Confusional state

Frequency not reported: Depression, insomnia, disturbance in attention^[Ref]

Nervous system

Common (1% to 10%): Headache, dizziness, syncope

Uncommon (0.1% to 1%): Paresthesia, dysgeusia, ageusia, somnolence

Rare (less than 0.1%): Tremor, balance disorder

Frequency not reported: Smell disturbance, amnesia, convulsions, neuralgia, neuropathy, cerebral ischemia, ischemic stroke, transient ischemic attack, psychomotor skills impaired, burning sensation, parosmia^[Ref]

Musculoskeletal

Common (1% to 10%): Muscle spasm, myalgia

Uncommon (0.1% to 1%): Arthralgia

Frequency not reported: Arthritis^[Ref]

Dermatologic

Common (1% to 10%): Maculopapular rash

Uncommon (0.1% to 1%): Pruritus, hyperhidrosis

Rare (less than 0.1%): Exfoliative dermatitis, urticaria, onycholysis

Frequency not reported: Purpura, pemphigus, pemphigoid, erythema multiforme, toxic epidermal necrolysis, Stevens Johnson syndrome, sweating increased, alopecia, psoriasis aggravated, dermatitis psoriasiform, lichenoid exanthema, enanthema^[Ref]

Renal

Common (1% to 10%): Abnormal kidney function

Uncommon (0.1% to 1%): Renal impairment, acute renal failure^[Ref]

Metabolic

Common (1% to 10%): Creatinine increased, blood potassium increased

Uncommon (0.1% to 1%): Anorexia, decreased appetite, BUN increased

Frequency not reported: Weight gain, hyponatremia, loss of appetite, uric acid elevated, blood glucose elevated, blood sodium decreased

Postmarketing reports: Hypoglycemia^[Ref]

Genitourinary

Uncommon (0.1% to 1%): Worsening of preexisting proteinuria, urine output increased, transient erectile impotence

Frequency not reported: Proteinuria, impotence^[Ref]

Ocular

Uncommon (0.1% to 1%): Visual disturbance, blurred vision^[Ref]

Hematologic

Uncommon (0.1% to 1%): Eosinophilia, hemoglobin or hematocrit decreased

Rare (less than 0.1%): Neutropenia, agranulocytosis, white blood cell count decreased, red blood cell count decreased, platelet count decreased

Frequency not reported: Pancytopenia, hemolytic anemia, thrombocytopenia, leucopenia, bone marrow failure^[Ref]

Hepatic

Uncommon (0.1% to 1%): Hepatic enzymes increased, conjugated bilirubin increased

Rare (less than 0.1%): Cholestatic jaundice, hepatocellular damage

Frequency not reported: Hepatic failure, hepatitis, jaundice, acute liver failure, hepatocellular damage, cholestatic hepatitis, cytolytic hepatitis, serum bilirubin elevated^[Ref]