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Ramipril (By mouth)
Treats high blood pressure (hypertension) and heart failure. Reduces risk of heart attack, stroke, and death in people 55 years of age or older who have heart disease. This medicine is an ACE (angiotensin-converting enzyme) inhibitor.
There may be other brand names for this medicine.
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to ramipril or to any other ACE inhibitor (such as captopril, enalapril, lisinopril, Accupril®, Lotrel®, or Zestril®). You should not use this medicine if you are pregnant (especially in your second or third trimester) or breastfeeding. Do not use this medicine if you have a history of angioedema (swelling of the face, lips, tongue, or throat).
How to Use This Medicine
- Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
- After you receive your first dose of this medicine, your caregiver will observe you for at least 2 hours. This is to make sure you do not have any serious side effects from this medicine.
- Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.
- Swallow the capsule or tablet whole. If you cannot swallow the capsule, you may open it and pour the medicine into 4 ounces (½ cup) of applesauce, water, or apple juice. Swallow this mixture whole, and use the mixture within 24 hours after mixing it.
- Carefully follow your doctor's instructions about any special diet. Be sure to drink plenty of fluids if you exercise, sweat more than usual, or have diarrhea or vomiting.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
How to Store and Dispose of This Medicine
- Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Any medicine that has been mixed with apple juice or applesauce may be stored in a refrigerator and used within 48 hours.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are using other medicine for high blood pressure (such as atenolol, lisinopril, metoprolol, quinapril, telmisartan, timolol, Accupril®, Micardis®, or Toprol®) or a diuretic or "water pill" (such as amiloride, furosemide, hydrochlorothiazide [HCTZ], spironolactone, torsemide, triamterene, Aldactone®, Demadex®, Lasix®, or Zaroxolyn®).
- Make sure your doctor knows if are also using lithium (Eskalith®, Lithobid®), sodium aurothiomalate (injectable gold), pain or arthritis medicine (such as aspirin, diclofenac, etodolac, ibuprofen, indomethacin, naproxen, Advil®, Ecotrin®, Feldene®, Motrin®, or Relafen®), or any diabetes medicine that you take by mouth.
- Do not use potassium supplements or salt substitutes that contain potassium without asking your doctor first.
- Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
Warnings While Using This Medicine
- Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
- Make sure your doctor knows if you have kidney disease, liver disease, congestive heart failure, heart disease, dehydration, low blood pressure, or low blood volume. Tell your doctor if you have a collagen-vascular disease such as lupus or scleroderma.
- This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your face, hands, arms, legs, feet, lips, tongue, or throat.
- This medicine may make you dizzy or lightheaded. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
- This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
- Liver problems may occur while you are using this medicine. Stop using this medicine and check with your doctor right away if you are having more than one of these symptoms: abdominal pain or tenderness; clay-colored stools; dark urine; decreased appetite; fever; headache; itching; loss of appetite; nausea and vomiting; skin rash; swelling of the feet or lower legs; unusual tiredness or weakness; or yellow eyes or skin.
- Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
- This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
- Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood tests may be needed to check for unwanted effects.
- If you stop using this medicine, your blood pressure may go up. High blood pressure usually has no symptoms. Even if you feel well, do not stop using the medicine without asking your doctor.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Blistering, peeling, or red skin rash.
- Change in how much or how often you urinate.
- Chest pain.
- Confusion, weakness, uneven heartbeat, shortness of breath, or numbness or tingling in your hands, feet, or lips.
- Dark-colored urine or pale stools.
- Fever, chills, cough, sore throat, and body aches.
- Lightheadedness, dizziness, or fainting.
- Nausea, vomiting, loss of appetite, or pain in your upper stomach.
- Severe stomach pain (with or without nausea or vomiting)
- Yellowing of your skin or the whites of your eyes.
If you notice these less serious side effects, talk with your doctor:
- Anxiety, tremors, trouble sleeping, or nervousness.
- Body and joint pains.
- Dry mouth, excess salivation, or change in taste.
- Headache, tired feeling.
- Mild nausea, vomiting, diarrhea, or constipation.
- Ringing in your ears or blurred vision.
- Trouble having sex (men).
If you notice other side effects that you think are caused by this medicine, tell your doctor