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ACE inhibitor (angiotensin-converting enzyme inhibitor)

Ramipril: uses, side effects & precautions

Also known as Altace, Tritace, Cardace.

This information is for general guidance only and does not constitute medical advice. Always consult a qualified healthcare professional for personal medical concerns. In an emergency, call your local emergency number.

What it is used for

  • High blood pressure (hypertension)
  • Heart failure
  • Reducing the risk of heart attack and stroke in high-risk people
  • Protecting the heart after a heart attack

How it works

Ramipril blocks an enzyme that produces a hormone (angiotensin II) that narrows blood vessels. With less of this hormone, vessels relax and widen, lowering blood pressure and reducing the workload on the heart.

How it is taken

Taken by mouth as a tablet or capsule, usually once a day with or without food. Take it exactly as your doctor or pharmacist directs and follow the label. Do not stop on your own; your clinician may check kidney function and potassium with blood tests.

No doses here on purpose. The right strength and schedule depend on you — only a doctor or pharmacist should set them. Always follow your prescription and the label.

Common side effects

  • Dry, persistent cough
  • Dizziness, especially when standing
  • Headache
  • Tiredness
  • Mild rise in blood potassium

Serious effects — get help

  • Swelling of the face, lips, tongue or throat, or trouble breathing (angioedema) — seek emergency care
  • Fainting
  • Signs of high potassium such as muscle weakness or irregular heartbeat
  • Reduced urination or signs of kidney problems

If a reaction is severe — for example trouble breathing, swelling of the face or throat, or collapse — go to the nearest emergency room now or call your local emergency number. Do not wait for an online consultation.

Interactions to watch

  • Potassium supplements and potassium-containing salt substitutes
  • Potassium-sparing diuretics such as spironolactone
  • ARBs and other blood pressure medicines (avoid combining without advice)
  • Non-steroidal anti-inflammatory drugs such as ibuprofen
  • Lithium
  • Some diabetes medicines

Who should take care

  • Do NOT use in pregnancy — it can harm the unborn baby; tell your doctor if you become or plan to become pregnant
  • Tell your clinician about kidney disease or narrowing of the kidney arteries
  • Avoid potassium-based salt substitutes unless advised
  • Dizziness risk is higher if dehydrated or on a water pill
  • Mention any history of angioedema

Frequently asked questions

Why might the first dose make me dizzy?
ACE inhibitors can lower blood pressure noticeably with the first doses, especially if you are also on a water pill. Take the first dose as advised, stand up slowly, and report severe dizziness.
Is the dry cough dangerous?
No, but it can be bothersome. Tell your clinician, who may switch you to a different class such as an ARB if needed.
Can I take it while pregnant?
No. ACE inhibitors can seriously harm a developing baby. Inform your doctor immediately if you are or may become pregnant.
Why is it used for more than blood pressure?
Ramipril also helps protect the heart and blood vessels, so it is prescribed to lower the risk of heart attack and stroke in some high-risk people.
Is Ramipril safe to take?
For most people it is safe when taken exactly as a doctor or pharmacist advises and as printed on the label. Tell your clinician about your other medicines and health conditions, and seek urgent care for any serious reaction.

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