Ramipril (patient information)

# IMPORTANT WARNING
Do not take ramipril if you are pregnant. If you become pregnant while taking ramipril, call your doctor immediately. Ramipril may harm the fetus.

# Why this medication is prescribed
Ramipril is used alone or in combination with other medications to treat high blood pressure. It is also used to reduce the risk of heart attack and stroke in patients at risk for these problems and to improve survival in patients with heart failure after a heart attack. Ramipril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.

# How this medication should be used
Ramipril comes as a capsule to take by mouth. It is usually taken once or twice a day with or without food. To help you remember to take ramipril, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ramipril exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the capsule whole, or open the capsule and sprinkle the contents on a small amount of applesauce (about 4 oz.) or in 4 oz. of water or apple juice. Eat or drink the entire mixture. This mixture can be prepared in advance and stored for 24 hours at room temperature or 48 hours in the refrigerator.
Your doctor will probably start you on a low dose of ramipril and gradually increase your dose.
Ramipril controls high blood pressure and heart failure but does not cure them. Continue to take ramipril even if you feel well. Do not stop taking ramipril without talking to your doctor.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special Precautions
Before taking ramipril:
- tell your doctor and pharmacist if you are allergic to ramipril, benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), trandolapril (Mavik), or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as indomethacin (Indocin); diuretics ('water pills'); lithium (Eskalith, Lithobid); and potassium supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had heart, liver, or kidney disease; lupus; scleroderma; diabetes; or angioedema, a condition that causes difficulty swallowing or breathing and painful swelling of the the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs.
- tell your doctor if you plan to become pregnant or are breast-feeding.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ramipril.
- you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting.

# Special dietary instructions
Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

# What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side Effects

## Minor Side Effects
Ramipril may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- headache
- dizziness
- cough
- upset stomach
- vomiting
- excessive tiredness
- weakness

## Severe Side Effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hoarseness
- difficulty breathing or swallowing
- yellowing of the skin or eyes
- fever, sore throat, chills, and other signs of infection
- lightheadedness
- fainting
Ramipril may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- lightheadedness
- fainting

# Other information
Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to ramipril. Your doctor may order certain lab tests to check your body's response to ramipril.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Altace