Indications |
Oral Hypertension Adult: Initially, 1.25 mg once daily given at bedtime. Maintenance: 2.5-5 mg daily as a single dose, up to 10 mg daily as needed.
Oral Heart failure Adult: Initially, 1.25 mg once daily. Max dose: 10 mg daily. Doses ≥2.5 mg may be given in 2 divided doses. Max Dosage: 10 mg daily in 1-2 divided doses.
Oral Post myocardial infarction Adult: Initially, 2.5 mg bid increased after 2 days to 5 mg bid. Start treatment 3-10 days after infarction. Usual dose: 2.5-5 mg bid.
Oral Prophylaxis of cardiovascular events in high-risk patients Adult: Initially, 2.5 mg once daily increased to 5 mg once daily after 1 wk if tolerated. Maintenance: 10 mg once daily after a further 3 wk.
Special Populations: Reduce dose in patients with renal impairment. |
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Contraindications |
Hypersensitivity, bilateral renal artery stenosis, or a single kidney with unilateral renal artery stenosis. Aortic stenosis or outflow tract obstruction. Pregnancy and lactation. | ||||||||||||||||||||||||
Warnings / Precautions |
Renal impairment, hypovolaemia, hyperkalaemia, valvular stenosis; before, during or immediately after anaesthesia. Severe resistant hypertension, elderly, peripheral vascular disease or generalised atherosclerosis. Monitor renal function before and during treatment. Use with caution in patients with history of idiopathic or hereditary angioedema. Regular monitoring of WBC in patients with vascular collagen disorders is recommended. | ||||||||||||||||||||||||
Adverse Reactions |
Nausea, vomiting, diarrhoea, dizziness, fatigue, headache, abdominal pain, cough. Rarely symptomatic hypotension. Angioneurotic oedema of face, lips, tongue, glottis and larynx, syncope, renal impairment, hypersensitivity reactions. Potentially Fatal: Severe hypotension and renal failure, angioedema. |
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Overdose Reactions |
May lead to severe hypotension. Normal saline infusion may be used for treatment. | ||||||||||||||||||||||||
Drug Interactions |
NSAIDs may increase risk of deterioration of renal function. Potentially Fatal: Concomitant admin of diuretics may lead to serious hypotension. Severe hyperkalaemia may result when used with potassium-sparing diuretics, potasisum supplements and drugs that cause hyperkalaemia. May increase serum lithium concentration. See Below for More ramipril Drug Interactions |
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Mechanism of Actions |
Ramipril is an ACE inhibitor which is metabolised into the active metabolite ramiprilat. It competitively inhibits angiotensin-converting enzyme (ACE) from converting angiotensin I to angiotensin II resulting in increased plasma renin activity and reduced aldosterone secretion. It also increases bradykinin levels. By these mechanisms, ramipril produces a hypotensive effect and a beneficial effect in CHF. Absorption: 50-60% is absorbed from the GI tract (oral); peak plasma concentrations after 2-4 hr (ramiprilat). Distribution: Protein-binding: 56%. Metabolism: Hepatic: Converted to ramiprilat. Excretion: Via urine (60% of the dose), via faeces (remaining dose); 13-17 hr (elimination half-life), may be prolonged in renal impairment. |
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Administration |
May be taken with or without food. |
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ATC Classification |
C09AA05 - ramipril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease. | ||||||||||||||||||||||||
Available As |
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Ramipril
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Ramipril Containing Brands
Ramipril is used in following diseases
Drug - Drug Interactions of Ramipril
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