Ramipril is used on its own or together with other medicines to keep your blood pressure under control. This medicine relaxes your blood vessels and helps to lower your blood pressure.
Ramipril may also be used to treat other conditions such as heart failure and heart attack. It can also help reduce the risk of heart attack, stroke, and kidney damages.
Take Ramipril exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Ramipril is available as a tablet or capsule.
If you are taking the tablet, swallow it whole with a glass of water.
If you are taking the capsule, swallow it whole with a glass of water or it may be opened and sprinkled on applesauce or dissolved in apple juice or water.
This medicine must be taken regularly for it to be effective. Continue taking Ramipril even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, inform your doctor and pharmacist.
Alert your doctor if you have the following conditions:
- previously experienced a serious allergic reaction which causes swelling of the face and throat due to an unknown reason or a family history
- undergoing dialysis or any other type of blood filtration using certain types of machines e.g. machines with high-flux (large pores) membranes
- renal artery stenosis (decreased blood supply to the kidney)
- low blood pressure
as Ramipril may not be suitable for you.
Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with this medicine, alert your doctor immediately. Ramipril may cause harm to your unborn child. You must use proven birth control methods while taking this medicine.
Do not take this medicine if you are breastfeeding.
Do not take this medicine if you have taken or currently taking sacubitril/valsartan or other medicines used to treat high blood pressure if you have diabetes and kidney disease. Please see the section “Can I take this with other medicines?” below for more information.
Inform your doctor if you have the following conditions:
- other heart diseases such as narrowing of the heart valves
- disorder of the blood vessels to the brain
- severe hypertension
- kidney disease
- liver disease
- immune system diseases affecting collagen e.g. systemic lupus erythematosus (autoimmune disease that causes inflammation)
- uncontrolled diabetes
- low sodium levels in the blood or fluid loss caused by water pills, dietary salt restriction, diarrhoea, or vomiting
- hypoaldosteronism (deficiency in a hormone called aldosterone)
Be sure to check with your doctor or pharmacist before giving this medicine to the elderly. Elderly people may be more sensitive to the side effects.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.
If you are of a Black race, Ramipril may be less effective. Inform your doctor if you are taking this medicine.
If you are going to undergo certain laboratory tests or treatment to reduce allergy to bee or wasp stings (desensitisation), inform your doctor that you are using this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
What lifestyle changes can I make to improve my blood pressure?
- Pregnancy test must be done before treatment to know if this medicine is suited for you to take.
- Routine tests (e.g. kidney function, electrolyte levels, complete blood count with differentials) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure during treatment.
- Regular monitoring of skin or allergic reactions may also be needed.
Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains, and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol, and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.
If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart, and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.
Ramipril may cause dizziness. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: cough, tiredness, headache, rash, diarrhoea, nausea, vomiting, stomach discomfort, indigestion, and muscle pain.
You may experience dizziness when getting up from a sitting or lying down position, especially if you are taking this medicine for the first time. This is common and should disappear gradually as you get used to this medicine. It will help if you get up slowly from a sitting or lying position.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes or mouth, hands, and legs
- rashes with peeling of the skin or blistering of the lips, mouth, or eyes accompanied by fever
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
- muscle weakness, cramping or numbness; fast or irregular heartbeat
Ramipril may cause the level of your red blood cells, white blood cells, and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds, and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever or a cough or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Ramipril with aliskiren (medicine used to treat high blood pressure) and other medicines for high blood pressure if you have diabetes or kidney disease.
Do not take this medicine if you have taken or currently taking sacubitril/valsartan (medicine used to treat high blood pressure).
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- medicines used in organ transplant or certain immune disorders e.g. ciclosporin, everolimus, sirolimus, tacrolimus
- lithium (medicine for mood disorders)
- other medicines for high blood pressure e.g. doxazosin, prazosin
- medicines for pain and inflammation e.g. aspirin, ibuprofen, indometacin
- medicines for diabetes e.g. insulin, vildagliptin
- potassium supplements (either as a medicine or as a salt substitute)
- medicines to treat enlarged prostate e.g. alfuzosin, terazosin, tamsulosin
- "water pills"
- medicines to treat depression known as tricyclic antidepressants (TCAs) e.g. imipramine
- racecadotril (medicine to treat diarrhoea)
- heparin (blood-thinning medicine)
- trimethoprim/sulfamethoxazole (antibiotic)
- allopurinol (medicine for gout)
- anti-inflammatory medicines e.g. prednisone
- medicines to block pain and sensation e.g. isoflurane
- medicines for heart diseases e.g. nitroglycerin, isosorbide mononitrate, isosorbide dinitrate
This list does not include all medicines that may interact with Ramipril.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Cut down on your salt intake. This may help lower your blood pressure and improve your overall health. Discuss with your doctor or dietitian about ways to cut down on your salt intake.
Avoid excessive consumption of alcohol. You may speak with your doctor if you have a drinking problem.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.