Overview
Ramipril is an ACE inhibitor used primarily for hypertension and heart failure management. It works by blocking the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. This leads to decreased blood pressure and reduced cardiac workload.
Mechanism of Action
Ramipril is an angiotensin-converting enzyme (ACE) inhibitor that prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This results in vasodilation, reduced aldosterone secretion, decreased sodium and water retention, and lowered blood pressure.
Indications
- Treatment of hypertension
- Management of heart failure post-myocardial infarction
- Reduction of cardiovascular events in high-risk patients
Common Doses
- 1.25 mg
- 2.5 mg
- 5 mg
- 10 mg
Dosage
Initial dose typically 2.5 mg once daily, titrated up to 10 mg daily based on response. For heart failure, start with 1.25 mg twice daily. Administer orally, with or without food.
Contraindications
- History of angioedema related to previous ACE inhibitor therapy
- Hypersensitivity to ramipril or other ACE inhibitors
- Concomitant use with aliskiren in patients with diabetes
Side Effects
- Cough (most common)
- Dizziness
- Headache
- Fatigue
- Hypotension
- Hyperkalemia
- Renal impairment
- Angioedema (serious)
Interactions
- Diuretics (increased hypotension risk)
- Potassium supplements/potassium-sparing diuretics (hyperkalemia risk)
- NSAIDs (reduced antihypertensive effect, renal impairment risk)
- Lithium (increased lithium levels)
Counseling Points
- Take consistently with or without food
- Report persistent cough, swelling of face/lips, or dizziness
- Monitor blood pressure regularly
- Avoid potassium supplements unless prescribed
- Stay hydrated, especially in hot weather or during illness