Ramipril, Oral

What are other names for this medicine?

Type of medicine: ACE inhibitor

Generic and brand names: ramipril, oral; Altace

What is this medicine used for?

This medicine is called an ACE inhibitor. It is taken by mouth to treat and control:

• high blood pressure
• heart failure
• risk of heart attack, stroke, or death in those at high risk for these problems.

It may be given to improve heart function after a heart attack.

This medicine may be used for other conditions as determined by your healthcare provider.

You may take this medicine alone or with other medicines.

What should my healthcare provider know before I take this medicine?

Before you start taking this medicine, tell your healthcare provider about any other medicines you are taking, including nonprescription products.

Tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• an autoimmune disease such as lupus, or any other immune system problem
• heart valve problems
• liver or kidney problems.

Tell your healthcare provider if you have been on a low-salt diet or have ever had problems with low blood levels of sodium.

Females of childbearing age: This medicine is not usually given to pregnant women because it can harm the baby. If you are pregnant, tell your healthcare provider. Do not become pregnant during treatment with this medicine. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while you are receiving this medicine.

How do I take it?

Take this medicine exactly as your healthcare provider prescribes. Take it regularly every day even if you feel better. Do not stop taking this medicine unless your healthcare provider approves. You may need to take this medicine for a long time to control your blood pressure. If your provider has also prescribed another medicine, take it regularly.

This medicine may come in different forms. Take this medicine with plain water. Tablets may be crushed to make them easier to swallow.

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What should I watch out for?

This medicine may make you lightheaded or dizzy. Do not drive or operate machinery unless you are fully alert.

This medicine may cause a sudden drop in blood pressure, especially when you first start taking it. You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. If you feel dizzy or faint while you are standing, lie down for a while and then get up slowly.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. Avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. If you develop a severe sunburn, contact your healthcare provider.

A persistent dry cough is common with this medicine. If the cough changes or becomes bothersome, talk to your healthcare provider. Do not take nonprescription cough medicines. The cough will go away after the medicine is stopped.

Ask your healthcare provider if you can use a salt substitute containing potassium or a potassium supplement while you are taking this medicine. Do not use salt substitutes or supplements containing potassium unless your provider approves. Talk to your provider before you take a potassium-sparing diuretic such as amiloride (Midamor), spironolactone (Aldactone), or triamterene (Dyrenium).

Be careful when exercising. This medicine may make you feel lightheaded, dizzy, or faint, especially in hot weather.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Your healthcare provider will want to see you regularly to check your blood pressure and to adjust your dosage, if necessary.

You may get infections more easily when you are taking this medicine. If you have any sign of infection, such as a sore throat or fever, contact your healthcare provider.

Diabetics: This medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives, itching, tightness in your chest, trouble breathing); chest pain; irregular or fast heartbeat; swelling of your face, lips, tongue, or throat; severe dizziness or fainting; trouble swallowing; severe abdominal pain.

Serious (Report these to your healthcare provider right away): Mouth sores; any signs of infection such as sore throat or fever; swelling of the hands or feet; unusual sweating, vomiting, or diarrhea; yellowing of the skin or eyes.

Other: Headache, dizziness, lightheadedness, tiredness, drowsiness, weakness, nausea, vomiting, diarrhea, back pain, cough, pain in the arms, headache, dry cough, change in sense of taste.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• allopurinol (Zyloprim)
• antacids such as Maalox, Mylanta, and Tums (take them at least 2 hours before or after this medicine)
• antiadrenergics such as clonidine/chlorthalidone (Combipres), guanabenz (Wytensin), guanfacine (Tenex ), and methyldopa (Aldomet)
• aspirin and other salicylates
• capsaicin (Zostrix, Capzasin-P, Capsin)
• diabetes medicines such as insulin, glyburide (DiaBeta, Micronase), glipizide (Glucotrol), repaglinide (Prandin), metformin (Glucophage), pramlintide (Symlin), rosiglitazone (Avandia), and pioglitazone (Actos)
• diuretics such as hydrochlorothiazide (Microzide, Oretic), furosemide (Lasix), chlorothiazide (Diuril), bumetanide (Bumex), torsemide (Demadex), spironolactone (Aldactone), triamterene (Dyrenium), eplerenone (Inspra), and amiloride (Midamor)
• herbal remedies such as arginine, cats claw, devils claw, ginger, goldenseal, hawthorn, horny goat weed, kelp, nettle, yohimbe, dong quai, ma huang, ginseng, natural licorice, and garlic
• immunosuppressants such as azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), mycophenolate mofetil (CellCept), sirolimus (Rapamune), and tacrolimus (Prograf, Protopic)
• lithium (Lithane, Lithobid, Lithotabs, Eskalith)
• nesiritide (Natrecor)
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, Nuprin), naproxen (Aleve, Naprosyn), indomethacin (Indocin), nabumetone (Relafen), hydrocodone/ibuprofen (Vicoprofen), ketoprofen (Orudis, Orudis KT), ketorolac (Toradol), and celecoxib (Celebrex)
• phenothiazines such as chlorpromazine (Thorazine), prochlorperazine (Compazine), perphenazine, promazine (Sparine), thioridazine, and trifluoperazine (Stelazine)
• potassium supplements such as K-Dur, Kaochlor, Kaon, Kaon-Cl, Kay Ciel, Klor-Con, Klorvess, K-Lyte, K-Lor, and Micro-K, and Slow-K
• rifampin (Rifadin, Rimactane)
• salt substitutes containing potassium

Do not drink alcohol while taking this medicine unless your healthcare provider approves.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.