Ramipril is a type of medicine known as an angiotensin-converting enzyme (ACE) inhibitor. It is used to treat high blood pressure (hypertension) and heart failure. Treating high blood pressure helps to prevent heart attacks, strokes and kidney problems.
Ramipril is an angiotensin-converting enzyme inhibitor (ACE inhibitor). Angiotensin-converting enzyme is involved in the production of a hormone called angiotensin II, which causes constriction of the vessels and elevation of blood pressure. Therefore, by inhibiting the production of this hormone, vessels relax and blood pressure is reduced. This reduces the effort required by the heart to pump blood around the body.
Ramipril will begin to lower blood pressure within just a few hours, but it will take a few weeks to have full effect.
The active ingredient in ramipril tablets is ramipril.
The inactive ingredients in ramipril are hypromellose, pregelatinised maize starch, microcrystalline cellulose, and sodium stearyl fumarate. The 2.5mg tablets also contain yellow ferric oxide (E172), and the 5 mg tablets also contain red ferric oxide (E172).
Please note: Different manufacturers of generic ramipril may use different inactive ingredients in their drugs than those listed here.
Never start taking ramipril without the instruction of a doctor. To begin with, a doctor will start you on a low dose to reduce the risk of side effects. You can then build-up to the dose recommended for your condition. Take ramipril once a day at the same time each day. Tablets should be swallowed whole with water and should not be crushed or split.
Always take ramipril as instructed by a doctor. The usual starting dose of ramipril is 1.25–2.5mg taken once daily and can be increased gradually over time until your blood pressure is controlled. For the treatment of high blood pressure, heart failure, for reducing the risk of heart attack or stroke or for treatment following a heart attack, the maximum daily dosage is 10mg.
It is sometimes advised to take ramipril before bed, particularly the first dose, as it can make you feel dizzy.
Like all medications, ramipril can cause side effects in some people. Stop taking ramipril and see a doctor immediately if you experience any of the following serious side effects:
Common side effects (affecting up to 1 in 10 people) include:
Uncommon side effects can affect up to 1 in 100 people and include:
The following rare side effects can affect up to 1 in 1,000 people:
Other side effects (frequency not known):
Do NOT take ramipril if you:
Before taking ramipril, tell your doctor if any of the following apply to you:
Before taking ramipril, tell your doctor if you are taking any other medicines, including those purchased over the counter without a prescription.
In particular, tell your doctor if you are taking any of the following:
The most common side effect of ramipril is dizziness, and your doctor will start by prescribing a low dose so that your body can adjust to the treatment. If you feel dizzy, or experience blurred vision, stop what you are doing and find somewhere to lie down until it has passed. Do not try to drive, ride a bike, or operate heavy machinery. Some people may experience headaches while taking ramipril, which can be managed by drinking plenty of fluids and taking painkillers if necessary. However, if headaches persist for longer than a week, speak to your doctor for advice.
Tell your doctor if you are pregnant or are planning to become pregnant. The use of ACE inhibitors is contraindicated in pregnancy, as it can be harmful to your baby. If you become pregnant while taking ramipril, consult your doctor immediately. Ramipril should not be taken while breastfeeding.
Alcohol can increase the blood pressure-lowering effect of ramipril and cause you to feel dizzy or lightheaded. You should avoid alcohol altogether when you first start taking ramipril, or if you continue to experience dizziness during treatment.
If you experience dizziness or blurred vision while taking ramipril, do not drive or ride a bike.
There are a few different options available for treating high blood pressure. Patients who are over the age of 55 or of Afro-Caribbean descent may be better suited to an alternative treatment, as ACE inhibitors are thought to be less effective for these groups. Alternative medications for treating high blood pressure include ACE inhibitors, diuretics, angiotensin receptor blockers (ARB) and beta-blockers. Speak to a doctor to find out which type of blood pressure medication is best for you.
Alongside treatment, it is important to make a few lifestyle changes to boost the health of your heart. Eating too much salt is one of the main causes of high blood pressure, so try not to eat more than 6g of salt per day. Try also to cut back on fatty foods, and include plenty of fruit and vegetables, whole grains and lean protein. Exercising regularly helps to keep your heart and blood vessels in good condition and also help you deal with stress. Stress can cause your blood pressure to rise so try to find ways to avoid it, such as spending time with friends and family, going for walks and giving yourself time to relax where possible. If you haven’t already done so, quit smoking, and try and reduce the amount of alcohol you drink.
Ramipril and lisinopril are both ACE inhibitors that work in the same way with a similar risk of side effects. The active ingredient in ramipril is ramipril, and the active ingredient in lisinopril is lisinopril dihydrate. Ramipril has been shown to be more effective than lisinopril at reducing blood pressure and reducing mortality.
Never stop taking ramipril without first consulting a doctor, as this can cause a dangerous rise in blood pressure and increase your risk of experiencing a heart attack or stroke.
Even if your blood pressure is reduced, it is recommended that you continue to take ramipril. This medication is usually taken for life, as coming off it can cause your blood pressure to rise and lead to a heart attack or stroke.
If you are scheduled to undergo surgery that requires a general anaesthetic, let your doctor know if you are taking ramipril. They may advise you to stop taking it 24 hours before you undergo surgery.
Ramipril is intended for long-term use and is usually taken for the rest of your life.
Ramipril is not a statin. Statins are used in the treatment of high cholesterol. You may be prescribed both ramipril and a statin to reduce your overall risk of cardiovascular events.
Ramipril is not a beta-blocker, it is an ACE inhibitor. Both beta-blockers and ACE inhibitors are used to reduce blood pressure.
It can take several weeks before you get the full benefits of taking ramipril. If your condition does not improve or worsens, speak to your doctor for advice.