Ramipril

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.
CrCl (ml/min)Dosage Recommendation
10-30Initiate with 1.25 mg once daily. Max dose: 5 mg daily.
<10Initiate with 1.25 mg once daily. Max dose: 2.5 mg daily.
Hepatic impairment: Initiate with 1.25 mg once daily.
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.
CrCl (ml/min)Dosage Recommendation
10-30Initiate with 1.25 mg once daily. Max dose: 5 mg daily.
<10Initiate with 1.25 mg once daily. Max dose: 2.5 mg daily.
Hepatic impairment: Initiate with 1.25 mg once daily.
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.
CrCl (ml/min)Dosage Recommendation
10-30Initiate with 1.25 mg once daily. Max dose: 5 mg daily.
<10Initiate with 1.25 mg once daily. Max dose: 2.5 mg daily.
Hepatic impairment: Initiate with 1.25 mg once daily.
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.
CrCl (ml/min)Dosage Recommendation
10-30Initiate with 1.25 mg once daily. Max dose: 5 mg daily.
<10Initate with 1.25 mg once daily. Max dose: 2.5 mg daily.
Hepatic impairment: Initiate with 1.25 mg once daily.

Special Populations: Reduce dose in patients with renal impairment.
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.
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
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.
Administration
May be taken with or without food.
ATC Classification
C09AA05 - ramipril ; Belongs to the class of ACE inhibitors. Used in the treatment of cardiovascular disease.
Available As
  • Ramipril 1.25 mg
  • Ramipril 10 mg
  • Ramipril 2.5 mg
  • Ramipril 25 mg
  • Ramipril 5 mg
  • Subscribe for latest updates

    Subscribe to our e-mail newsletter to receive updates.

    No comments yet.

    Post Review about Ramipril


    Ramipril Containing Brands

    We are Developing Our database, More results coming soon.

    Ramipril is used in following diseases

    We are Developing Our database, More results coming soon.

    Drug - Drug Interactions of Ramipril

    We are Developing Our database, More results coming soon.