Ramipril

The US label lists three uses. First, treatment of hypertension to lower blood pressure, alone or with thiazide diuretics.

Second, in people aged 55 or older at high risk of a major cardiovascular event, to reduce the risk of heart attack, stroke or death from cardiovascular causes.

Third, in stable patients with clinical signs of heart failure after a heart attack.

• High blood pressure
• Lowering cardiovascular risk in high-risk adults aged 55 or older
• Heart failure after a heart attack

The label says ramipril and its active form, ramiprilat, block the angiotensin converting enzyme (ACE). This enzyme makes angiotensin II, a substance that narrows blood vessels.

With less angiotensin II, blood vessels relax and the body releases less aldosterone. The label says this may cause a small rise in potassium.

The US label says that for hypertension the initial dose is 2.5 mg to 20 mg once daily, adjusted after 2 to 4 weeks. The usual maintenance dose is 2.5 to 20 mg a day, as a single dose or divided.

To reduce cardiovascular risk, the label lists 2.5 mg once daily for 1 week, then 5 mg for 3 weeks, rising as tolerated to 10 mg once daily.

For heart failure after a heart attack, the label lists a starting dose of 2.5 mg twice daily, which may be reduced to 1.25 mg twice daily if blood pressure is low.

The label says to take care with potassium supplements, salt substitutes containing potassium and potassium-sparing diuretics. Kidney function and potassium may need to be checked.

Indian pack labels may differ from the US label, and your prescriber's instruction always comes first. Ask your doctor or pharmacist if anything is unclear.

• Hypertension: initial 2.5 mg to 20 mg once daily
• Adjusted after 2 to 4 weeks
• Heart failure after a heart attack: 2.5 mg twice daily to start

The boxed warning says that when pregnancy is detected, ramipril should be discontinued as soon as possible. Medicines that act on the renin-angiotensin system can injure and kill the developing baby.

Ramipril must not be used by people who had angioedema with an ACE inhibitor or who have hereditary or idiopathic angioedema. It must not be used with sacubitril, and not within 36 hours of switching to or from sacubitril/valsartan. It must not be used with aliskiren in people with diabetes.

The label says angioedema is more frequent in Black patients than in non-Black patients.

Kidney: monitor kidney function during treatment. Low blood pressure and high potassium can occur.

Breastfeeding: the label advises not to use ramipril in nursing mothers. Elderly: levels of the active form are higher in older patients, but safety and effectiveness did not differ overall.

The part of the label we reviewed does not describe alcohol or driving, so ask your doctor or pharmacist.

• Pregnancy or planning pregnancy
• Past angioedema
• Kidney problems
• Taking potassium supplements or salt substitutes
• Diabetes with aliskiren
• Breastfeeding
• Older age
• Taking diuretics

• Diuretics
• Potassium supplements, salt substitutes
• Sacubitril/valsartan and aliskiren
• Lithium
• NSAIDs
• mTOR inhibitors
• The label says diuretics may cause an excessive drop in blood pressure when ramipril is started.
• A lower starting dose may be needed.
• Potassium supplements, salt substitutes with potassium and potassium-sparing diuretics can cause high potassium.
• Check potassium levels in such patients.
• Combined use with other renin-angiotensin blockers should generally be avoided.
• Aliskiren must not be combined in people with diabetes.
• Lithium should be used with caution.
• NSAIDs can cause kidney problems and weaken the blood-pressure-lowering effect.
• mTOR inhibitors and neprilysin inhibitors can raise the risk of angioedema.

No match in this label text. Ask your pharmacist about any medicine you take.

The label says the most likely effect of overdose is low blood pressure. Human experience is limited.

Treatment is supportive. Seek emergency help for a suspected overdose.

The US label says to store capsules at 20 to 25 degrees C and to dispense them in a well-closed container with a safety closure.

Check the storage line on your own pack and leaflet. Keep out of the reach of children.

In the Drugs Rules schedules we checked, Ramipril is listed under Schedule H (Schedule H, serial 426 (rules 65 and 97)). It is sold on prescription.

The National List of Essential Medicines 2022 lists Ramipril in these forms: Tablet 5 mg.

NPPA ceiling prices exist for some Ramipril formulations. The table in the price section shows each row we found.

The Jan Aushadhi (PMBJP) product list we checked has 7 entries that name Ramipril. Availability at a Kendra can change.

Appears in 2 entries of the banned fixed-dose combination list we checked. Check any combination product before use.

• Jan Aushadhi: Ramipril Tablets IP 2.5 mg, pack 10's (row p10:sno231)
• Jan Aushadhi: Ramipril Tablets IP 5 mg, pack 10's (row p10:sno232)
• Jan Aushadhi: Ramipril 5mg and Hydrochlorothiazide 12.5mg Tablets IP, pack 10's (row p14:sno327)
• Jan Aushadhi: Ramipril 5mg and Amlodipine 5mg Tablets, pack 10's (row p15:sno344)
• Jan Aushadhi: Ramipril Tablets IP 10mg, pack 10's (row p64:sno1420)
• Jan Aushadhi: Ramipril 2.5mg and Hydrochlorothiazide12.5mg Tablets, pack 10's (row p76:sno1672)
• Jan Aushadhi: Ramipril Tablets IP 1.25mg, pack 10's (row p76:sno1673)

NPPA sets a ceiling price per unit for scheduled formulations. The table shows every Ramipril row we found.

A ceiling is the most a seller may charge per unit for that formulation. Actual prices are often lower. Check the pack and seller.

Some medicines appear under more than one NPPA category or date. Ask the pharmacist which row applies to your pack.

Jan Aushadhi lists 7 products that name Ramipril. Compare the pack size and strength with your prescription before switching, and ask your doctor or pharmacist.

We do not show brand prices because they change often and we have not verified them.