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Ramipril is an ACEI (Angiotension Converting Enzyme Inhibitor). It decreases the body’s production of angiotension 2, a molecule which causes vasoconstriction and increases blood pressure. It is used to treat conditions such as heart failure and high blood pressure.



How to Use


Take this medication by mouth with water, it can be taken with or without food.


Take it exactly as directed, do not take it more than directed.


If you miss a dose, take it as soon as you can. If it is already almost time for your next dose, take only that next dose. Do not double up on any dose.



Important Information


Inform your doctor if you are pregnant or may become pregnant while taking this medication, this medicine can have harmful effects on the unborn child.


Check your blood pressure and meet with your doctor regularly while taking this medication.  It is important to keep a close eye on your blood sugar if you are a diabetic.


Inform your doctor if you are experiencing diarrhea, vomiting, excessive sweating, or other causes of dehydration. Being dehydrated while taking this medication can have harmful effects.


If you are going to undergo a desensitization treatment with hymeneptera, dialysis, or surgery  inform your doctor that you are taking this medication.


Do not self treat yourself for coughs, colds, diarrhea, or allergies while on this medication. Consult with your doctor before doing so in order to decrease the chance of side effects.


Limiting your sodium intake to less than 1500mg/day, following the DASH diet, and maintaining a regular exercise schedule (see lifestyle tab) can drastically improve your blood pressure.



Be sure that your prescribing doctor is aware if you have any of the the following conditions before taking this medication


Diabetes, blood vessel conditions, heart conditions, immune system disorders, kidney disease, liver disease, low blood pressure, history of allergic reactions, pregnancy or breastfeeding, trying to become pregnant, any previous swelling of the face, tongue or lips, difficulty breathing, difficulty swallowing, horseness, feelings of tightening of the throat.



Side effects that should be immediately reported to your healthcare provider


Allergic reactions(hives, rashes, itching, swelling of the face or mouth), trouble breathing, abdominal pain, darkened urine, lightheadedness or fainting, dizziness, fever, sore throat, heart beat changes, chest pain, weakness, yellowing of skin or eyes, numbness or tingling in the toes or fingers.



Other Side Effects


Libido changes, changes in taste, cough, headache, fatigue.



Adult Dose


Hypertension(high blood pressure)


2.5 mg by mouth once daily as a starting dose. The usual maintenance dose is 2.5-20 mg  by mouth once daily or in 2 divided doses.



Myocardial Infarction


 2.5 mg by mouth twice daily as a starting dose. The dose is then increased to 5 mg by mouth twice daily as tolerated.



Peripheral Arterial Occlusive Disease:


10 mg by mouth once daily.



Heart Failure Signs Following an Acute Myocardial Infarction


Between 1.25 and 2.5 mg by mouth twice daily. If hypotension occurs from 2.5 mg, the dose should be reduced to 1.25 mg by mouth twice daily. The dose is gradually titrated to the target dose of 5 mg by mouth twice daily.



Myocardial Infarction and Stroke Prophylaxis (patients over 55 at high risk)


2.5 mg by mouth once daily. The dose is then gradually increased to 5 mg by mouth once daily. If tolerated the dose can be further increased to the target dose of 10 mg by mouth daily given in 1-2 divided doses.





1. Altace oral capsules, ramipril oral capsules[package insert].New York, NY: Pfizer; 2013.


2. Altace (ramipril) [package insert]. New York, NY: Pfizer; 2015.


3. Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000;342:145-153


4. Altace (ramipril) [package insert]. Bristol, TN: Monarch Pharmaceuticals, Inc.; 2014.

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