Ramipril

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.