What is ramipril?
Ramipril is an ACE inhibitor (Angiotensin-Converting-Enzym-Hemmer) and is one of the most commonly prescribed blood pressure medications in Germany. It is used to treat high blood pressure (hypertension), heart failure and to protect the kidneys in diabetes.
The active ingredient reliably reduces blood pressure and at the same time protects heart, vessels and kidneys from consequential damage to high blood pressure. Ramipril is taken once a day and is available as a generic by numerous manufacturers, including Ramipril-1 A Pharma®, Ramipril HEXAL® and Ramipril-ratiopharm®.
Ramipril is also available in combination preparations with amlodipine or hydrochlorothiazide (HCT).
Active Ingredients & Mechanism of Action
Active ingredient: Ramipril
Ramipril intervenes in the renin angiotensin aldosterone system (RAAS):
Active mechanism:
- Inhibits angiotensin converting enzyme (ACE)
- This forms less angiotensin II
- Angiotensin II is a strong vascular constrictor
- Less angiotensin II means: vessels widen, blood pressure drops
Additional effects:
- Reduces the Aldosterone distribution (less water and salt retention)
- Inhibits the degradation of bradykinin (vessel-extending)
- Protects heart and kidneys from remodeling processes
- Improves the function of the inner wall of the vessel (endothelium)
Initiation of action: The blood pressure-lowering effect begins after 1-2 hours. The maximum effect is achieved after 3-6 hours. Stable blood pressure reduction occurs after 3-4 weeks of regular intake.
Who is it suitable for?
Ramipril is suitable for:
- Adults with hypertension (arterial hypertension)
- Patients with heart failure
- After heart attack for post-treatment
- Patients with diabetic nephropathy
- For cardiovascular prevention in high-risk patients
Especially recommended at:
- Diabetes with high blood pressure
- Heart failure
- After heart attack
- Protein excretion in urine (Proteinurie)
Not suitable:
- Pregnancy and breastfeeding
- Side-side kidney arterial stenosis
- Angioedema in History
- Simultaneous application with aliens in diabetes
Available Dosages
High blood pressure:
- start dose: 2.5 mg once a day
- usual maintenance dose: 5-10 mg once a day
- Maximum dose: 10 mg daily
Sufficiency:
- start dose: 1.25 mg once a day
- Slow increase over weeks
- Target dose: 10 mg daily
Available starches:
- 1.25 mg, 2.5 mg, 5 mg, 10 mg tablets
Combination preparations:
- Ramipril + Amlodipine (e.g. Ramipril HEXAL® plus Amlodipine)
- Ramipril + Hydrochlorothiazide (e.g. Ramipril-1 A Pharma® plus)
How to Take
Intake:
- Once a day, always at the same time
- Independent meals
- Suck with sufficient water
- Do not chew tablet
Dosis adjustment:
- start with low dose
- Slow increase every 2-4 weeks
- Control blood pressure and kidney values regularly
Important notes:
- Don't suddenly stop – Reduce dose slowly
- Forgotten dose: Repeat if less than 12 hours have passed
- Regular blood pressure control recommended
- avoid potassium-containing salt substitutes
Contraindications
**Ramipril must not be taken at:* *
- hypersensitivity to ramipril or other ACE inhibitors
- Angioedema in prehistory (also hereditary)
- Side-sided kidney arterial stenosis
- Pregnancy and breastfeeding
- Simultaneous application with aliens in diabetics
Preview at:
- Restricted kidney function (dose adjustment)
- Aortenstenose or mitralstenose
- Increased potassium level
- Simultaneous dialysis
- Collagenoses (e.g. Lupus)
- Liver malfunction
pregnant: ACE inhibitors are contraindicated throughout pregnancy. You can cause severe malformations and damage to the unborn child. If you wish to change your child in time.
Possible Side Effects
Acid (1-10%):
- Dry stimulus cough (up to 10% of patients)
- Schwindel, especially at the beginning
- Headaches
- fatigue
- Increased potassium values
** Occasionally (0,1-1%):* *
- Blood pressure drop (particularly for initial administration)
- Kidney malfunction
- Skin rash
- Gastrointestinal complaints
- Taste disorders
Selten, but seriously:
- Angioedema (swelling of face, lips, tongue) – immediately call a doctor!
- High blood pressure drop
- Severe kidney function disorder
Reizhusten: The dry cough is the most common cause of changing the drug. It occurs in about 5-10% of patients and disappears after depletion. Alternative: Change to an AT1 blocker (Sartan).
Interactions
Contraint with:
- Aliskiren in diabetes or kidney failure
- Sacubitril/Valsartan (36 hours distance)
Preview with simultaneous use of:
- Potassium-saving diuretics (spironolactone, triamterene) – Hyperkaliemia
- NSAR (Ibuprofen, Diclofenac) – reduced effect, kidney damage
- Lithium – increased lithium levels
- Other blood pressure sinks – increased blood pressure reduction
- Antidiabetics – increased blood sugar reduction
Important: avoid potassium-containing supplements and salt substitutes. Regular control of kidneys and potassium recommended.
Frequently Asked Questions
Similar Medications
Is ramipril right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.