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Other brands with the same active ingredient
These brands contain the same active ingredient (Ramipril). Strength and form may differ — confirm substitution with your doctor or pharmacist before switching.
Indications & Uses
Ramace is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Dosage of Ramipril must be adjusted according to the patient's tolerance and response. Hypertension: for the management of hypertension in adults who are not receiving a diuretic, the usual initial dose of Ramipril is 1.25 to 2.5 mg once daily. The dose is generally adjusted no more rapidly than at 2 week intervals. The usual maintenance dose in adults is 2.5 to 20 mg daily, given as a single dose or in 2 divided doses daily. If BP is not controlled with Ramipril alone, a diuretic may be added. Congestive heart failure after myocardial infarction: in this case, Ramipril therapy may be started as early as 2 days after the myocardial infarction. An initial dose of 2.5 mg twice daily is recommended, but if hypotension occurs, the dose should be reduced to 1.25 mg twice daily. Therapy is then titrated to a target dose of 5 mg twice daily. Prevention of major cardiovascular events: in this case, the recommended dose is 2.5 mg once daily for the first week of therapy and 5 mg once daily for the following 3 weeks; the dose may then be increased, as tolerated, to a maintenance dose of 10 mg once daily. Dosage in renal impairment: for patients with hypertension and renal impairment, the recommended initial dose is 1.25 mg of Ramipril once daily. Subsequent doses should be titrated according to individual tolerance and BP response, up to a maximum of 5 mg daily. For patients with heart failure and renal impairment, the recommended dose is 1.25 mg once daily. The dose may be increased to 1.25 mg twice daily and up to a maximum of 2.5 mg twice daily, depending on clinical response and tolerability.
Side Effects
Ramipril is generally well tolerated. The most commonly reported side effects are dizziness, headache, fatigue and asthenia (weakness). Less frequent side effects include symptomatic low blood pressure (hypotension), cough, nausea, vomiting, diarrhoea, rash, urticaria (hives), reduced urine output (oliguria), anxiety and amnesia, among others. Rarely, angioneurotic oedema, anaphylactic reactions and hyperkalaemia (raised blood potassium) have also been reported.
Cautions & Contraindications
Warnings & Precautions
Ramipril should be used with caution in patients with impaired kidney function, high blood potassium levels (hyperkalaemia), low blood pressure (hypotension), or impaired liver function.
Contraindications
Ramipril must not be used in patients who are hypersensitive to ramipril, to any other ACE inhibitor, or to any of the excipients in the product. It is also contraindicated in patients with a history of angioedema, and it must not be taken together with sacubitril/valsartan. Ramipril should not be started until sacubitril/valsartan has been cleared from the body, and when switching from ramipril to sacubitril/valsartan, the latter should not be started until ramipril has been cleared from the body. Ramipril is contraindicated in patients with haemodynamically relevant renal artery stenosis, whether bilateral or unilateral in a single kidney, and in patients who are hypotensive or haemodynamically unstable. It must not be combined with aliskiren-containing medicines in patients with diabetes or with moderate to severe renal impairment (creatinine clearance below 60 ml/min), nor with angiotensin II receptor antagonists (AIIRAs) in patients with diabetic nephropathy. It must not be used during pregnancy. Combining ACE inhibitors with extracorporeal treatments that bring blood into contact with negatively charged surfaces must be avoided, as this may cause severe anaphylactoid reactions. Such treatments include dialysis or haemofiltration using certain high-flux membranes (for example polyacrylonitrile) and low-density lipoprotein apheresis with dextran sulfate.