Generic name: ramipril [ RAM-i-pril ]
Brand name: Altace
Drug class: Angiotensin Converting Enzyme Inhibitors

Medically reviewed by Melisa Puckey, BPharm. Last updated on Mar 1, 2024.

What is ramipril?

Ramipril is an ACE inhibitor. ACE stands for angiotensin converting enzyme.

Ramipril is used to treat high blood pressure (hypertension) or congestive heart failure, and to improve survival after a heart attack.

Ramipril may also be used for purposes not listed in this medication guide.

Warnings

Do not use ramipril if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away.

You should not use ramipril if you have ever had angioedema. Do not take this medicine within 36 hours before or after taking medicine that contains sacubatril (such as Entresto).

If you have diabetes, do not use ramipril together with any medication that contains aliskiren (such as Tekturna or Tekamlo).

Before taking this medicine

You should not use ramipril if you are allergic to it, or if:

• you have a history of angioedema;

• you recently took a heart medicine called sacubatril; or

• if you are allergic to any other ACE inhibitor, such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, or trandolapril.

Do not take ramipril within 36 hours before or after taking medicine that contains sacubatril (such as Entresto).

If you have diabetes, do not use ramipril together with any medication that contains aliskiren (such as Tekturna or Tekamlo).

You may also need to avoid taking ramipril with aliskiren if you have kidney disease.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);

• liver disease;

• a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis; or

• if you are also taking telmisartan (Micardis).

Do not use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. Ramipril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control.

It is not known whether ramipril passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take ramipril?

Take ramipril exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Ramipril can be taken with or without food.

Swallow the tablet whole.

You may open the capsule and sprinkle the medicine into a half-cup (4 ounces) of water, apple juice, or applesauce to make swallowing easier. Swallow without chewing. You may store the mixture for up to 24 hours at room temperature, or up to 48 hours in a refrigerator.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking ramipril. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

Your blood pressure will need to be checked often, and you may need frequent blood tests to check your potassium levels.

Drink plenty of water each day while you are taking this medication.

If you need surgery, tell the surgeon ahead of time that you are using this medicine.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Related/similar drugs

Wegovy, amlodipine, lisinopril, aspirin, metoprolol, losartan, furosemide, carvedilol, Ozempic, hydrochlorothiazide

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

Do not use salt substitutes or potassium supplements while taking ramipril, unless your doctor has told you to.

Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of ramipril.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Ramipril side effects

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

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• jaundice (yellowing of your skin or eyes);

• little or no urination;

• fever, chills, sore throat, cold or flu symptoms; or

• high potassium - nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common ramipril side effects may include:

• headache;

• cough; or

• dizziness, weakness, tired feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Frequently asked questions

• Do ACE inhibitors make COVID-19 worse?

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use ramipril only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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