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Indications/Uses
Ramipril is an ACE inhibitor. It is used in the treatment of hypertension, heart failure and following myocardial infarction to improve survival in patients with clinical evidence of heart failure. It is also used to reduce the risk of cardiovascular events in patients with certain risk factors.
Dosage/Direction for Use
In the treatment of hypertension: the initial dose is 1.25 mg once daily. The usual maintenance is 2.5 mg to 5 mg daily, although up to 10 mg daily maybe required or as prescribed by the physician.
In the management of heart failure: the initial dose is 1.25 mg once daily. The usual maximum dose is 10 mg daily; doses of 2.5 mg or more daily may be taken to 1 or 2 divided doses. Or as prescribed by the physician.
For myocardial infarction: the usual the initial dose is 2.5 mg or more daily maybe taken to 1 or 2 divided doses. Or as prescribed by the physician.
For the prophylaxis of cardiovascular events: the initial dose is 2.5 mg once daily. The dose should be increased, if tolerated, to 5 mg once daily after 1 week, then to the usual maintenance dose of 10 mg once daily after further 3 weeks. Or as prescribed by the physician.
In patients with hypertension or recent myocardial infarction it may also be given in divided doses.
In the management of heart failure: the initial dose is 1.25 mg once daily. The usual maximum dose is 10 mg daily; doses of 2.5 mg or more daily may be taken to 1 or 2 divided doses. Or as prescribed by the physician.
For myocardial infarction: the usual the initial dose is 2.5 mg or more daily maybe taken to 1 or 2 divided doses. Or as prescribed by the physician.
For the prophylaxis of cardiovascular events: the initial dose is 2.5 mg once daily. The dose should be increased, if tolerated, to 5 mg once daily after 1 week, then to the usual maintenance dose of 10 mg once daily after further 3 weeks. Or as prescribed by the physician.
In patients with hypertension or recent myocardial infarction it may also be given in divided doses.
Administration
May be taken with or without food.
Special Precautions
Ramipril should not be used in patients with aortic stenosis or outflow tract obstruction. It should be noted that the elderly or patients with peripheral vascular diseases or generalized atherosclerosis may be at high risk because they may have clinically silent renovascular disease. Renal function should be assessed in all patients prior to administration of ACE inhibitors and should be monitored during therapy. Ramipril should be used with caution in patients with a history of idiopathic or hereditary angioedema. It should also not be used during pregnancy. Ramipril should not be administered to women who are breastfeeding.
Use In Pregnancy & Lactation
Ramipril should not be administered to women who are breastfeeding.
Adverse Reactions
The effects include hypotension, dizziness, fatigue, gastrointestinal disturbances, taste disturbances, persistent dry cough and other respiratory tract symptoms, skin rashes (including erythema multiforme and toxic epidermal necrolysis), angioedema, hypersensitivity reactions, renal impairment, hypokalemia, hyponatremia and blood disorders.
Other adverse effects reported with ACE inhibitors include chest pain, palpitations, tachycardia, stomatitis, abdominal pain, pancreatitis, hepatocellular injury or cholestatic jaundice, alopecia, muscle cramps, paraesthesias, mood and sleep disturbances and impotence.
Other adverse effects reported with ACE inhibitors include chest pain, palpitations, tachycardia, stomatitis, abdominal pain, pancreatitis, hepatocellular injury or cholestatic jaundice, alopecia, muscle cramps, paraesthesias, mood and sleep disturbances and impotence.
Drug Interactions
The use of ACE inhibitors with potassium supplements, salt substitutes or diuretics (for example, spironolactone) that increase potassium in the blood may lead to excessive potassium levels. Potassium levels should be monitored whenever ACE inhibitors are used in combination with these drugs.
Storage
Store at temperatures not exceeding 30°C.
Action
Pharmacology: Pharmacokinetics: Ramipril acts as a prodrug of the diacid ramiprilat, its active metabolite. Following oral administration at least 50 to 60% is absorbed. Ramipril is metabolized in the liver to ramiprilat; other metabolites are inactive. Peak plasma concentrations of ramiprilat are achieved 2 to 4 hours after an oral dose of ramipril. Ramiprilat is about 56% bound to plasma proteins. About 60% of an oral dose of ramipril of an oral dose of ramipril is excreted in the urine, the rest in the feces. The effective half-life for accumulation of ramipril is 13 to 17 hours following multiple doses of ramipril 5 to 10 mg, but it is much longer for doses of 1.25 to 2.5 mg daily. The clearance of ramiprilat is reduced in renal impairment.
MedsGo Class
ACE Inhibitors/Direct Renin Inhibitors
Features
Brand
Ramipro
Full Details
Dosage Strength
5 mg
Drug Ingredients
- Ramipril
Drug Packaging
Tablet 1's
Generic Name
Ramipril
Dosage Form
Tablet
Registration Number
DR-XY32343
Drug Classification
Prescription Drug (RX)