Meds and you

Updated 11 February 2013


Ramipril is an angiotensin-converting enzyme (ACE) inhibitor prescribed for the treatment of high blood pressure and congestive heart failure.


Ramipril is the active ingredient of Austell-Ramipril, Ramace, Ramipril Hexal, Ramiwin, Rampil, Ran-Ramipril, Retace, Rilace, Siyala Ramipril, and Tritace.

Ramipril is also one of multiple active ingredients found in Tri-Plen and Tri-Plen Forte.

General Information

Ramipril is an angiotensin-converting enzyme (ACE) inhibitor prescribed for the treatment of high blood pressure and congestive heart failure, a condition where the heart battles to cope with its workload. It causes blood vessels to relax and widen, thereby reducing high blood pressure.

This medication is not a cure for high blood pressure, but is effective in keeping it under control. For it to be effective, you must take it regularly. High blood pressure declines slowly and it may take a few weeks for ramipril to achieve its full effect. Keep on taking the medicine during this period, even if you are feeling better or fail to notice any improvement.

Ramipril can be used on its own, or in combination with certain other medications for high blood pressure. It is often effectively combined with diuretics. In black patients ramipril is significantly less effective if not prescribed together with a diuretic.

The first couple of doses of this medication may cause a sudden drop in blood pressure, which may cause dizziness or blackouts when you suddenly get up. It is therefore advised that you should be resting when starting treatment and to lie down for 2 hours afterwards.

The use of ramipril is often associated with a dry and persistent cough. Should you notice an irritating cough while being treated with this drug, it is advised that you contact you doctor.

Ramipril should be avoided during pregnancy, especially the second and third trimester. Speak to your doctor about the use of this drug if you are planning to get pregnant, as it may cause harm to the unborn baby.

How does ramipril work?

Ramipril works by preventing the conversion of angiotensin I, a chemical in your blood, to a more powerful version, angiotensin II. Angiotensin II has a narrowing effect on blood vessels, thereby increasing blood pressure. Angiotensin II furthermore stimulates the production aldosterone, a hormone which promotes salt (sodium) retention in the body, an action which increases blood pressure.

By inhibiting the forming of angiotensin II ramipril lowers blood pressure and thereby decreases the workload on the heart.

Fast facts

Drug schedule: Schedule 3

Available as: Ramipril is available as tablets and capsules

What does it do? Lowers blood pressure

Overdose risk: Medium

Dependence risk: Low

Is ramipril available as a generic? Yes

Is ramipril available on prescription only? Yes

User information

Onset of effect: Within 2 hours

Duration of action: Up to 24 hours

Dietary advice: Ramipril should best be taken 1 hour before a meal on an empty stomach. One is advised to follow a low potassium diet, which includes foods such as tomatoes and bananas.

Stopping this medicine: Use ramipril as prescribed by your doctor and do not discontinue treatment before speaking to him/her. Suddenly discontinuing the drug may cause your blood pressure to increase dangerously. Dosage should be deceased gradually as directed by your doctor.

Prolonged use: No problems are expected. Your doctor may perform periodic tests of your blood and urine, should the need arise.

Special precautions

Consult your doctor before using this drug if:

  • You have a kidney disease
  • You are allergic to ACE-inhibitor drugs
  • You suffer from a heart or circulatory disorder
  • You suffer from Lupus Erythematosus
  • You are taking other medication
  • You are pregnant or planning to become pregnant.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

Elderly: Caution is advised and a reduction in dose may be needed.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.

Alcohol: Avoid concomitant use of alcohol with this medication as it may worsen the possibility of dizziness.

Possible side effects

Side effect


Consult your doctor



Only if severe

In all cases







Dry cough






Chest pain/palpitations



Altered sense of taste






Muscle cramps



Swelling of face, lips, tongue or throat



Swelling of arms and legs



Difficulty swallowing/breathing




Abdominal pain with/without nausea/vomiting




Drug interactions


Possible allergic reactions


Enhanced blood pressure-lowering effect

Other medication for high blood pressure

Enhanced blood pressure-lowering effect


Increased risk of potassium toxicity


Effect on blood pressure is enhanced.


Increased risk of lithium toxicity

Non-steroidal anti-inflammatory drugs

Effect on blood pressure is impaired.

Potassium supplements

Increased risk of potassium toxicity


May increase blood pressure.

Food interactions

A low potassium diet is advised. Foods such as tomatoes and bananas are high in potassium.

Disease interactions

Consult your doctor before using this drug if you have kidney disease, a heart condition your doctor is not aware of, or if you are allergic to ACE-inhibitor drugs.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention. Symptoms of an overdose may include dizziness and/or fainting.

Recommended dosage

High blood pressure: 5-10 mg/day as a single dose or in divided doses (for larger doses)


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