page_title: Ramipril
section_title: Mechanism of action
hierarchical_section_title: Ramipril / Mechanism of action
caption_attribution_description: English: Drug Name: Ramipril 1.25 MG Oral Capsule Ingredient(s): Ramipril Drug Label Imprint: RP;1;25 Color(s): Yellow Shape: Capsule	*Size (mm): 14.00 Score: 1 Inactive Ingredient(s): ShowHide starch, corn / gelatin / titanium dioxide / ferric... starch, corn / gelatin / titanium dioxide / ferric oxide yellow Drug Label Author: Cobalt Laboratories Inc. DEA Schedule: Non-scheduled
context_page_description: Ramipril, sold under the brand name Altace among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. Also used to prevent cardiovascular disease in those at high risk. It is a reasonable initial treatment for high blood pressure. It is taken by mouth.
  Common side effects include headaches, dizziness, feeling tired, and cough. Serious side effects may include liver problems, angioedema, kidney problems, and high blood potassium. Use in pregnancy and breastfeeding is not recommended. It is an ACE inhibitor and works by decreasing renin-angiotensin-aldosterone system activity.
  Ramipril was patented in 1981 and approved for medical use in 1989. It is available as a generic medication. A month supply in the United Kingdom costs the NHS less than £1 as of 2019. In the United States, the wholesale cost of this amount is about US$2. In 2017, it was the 134th most commonly prescribed medication in the United States, with more than five million prescriptions.
context_section_description: ACE inhibitors inhibit the actions of angiotensin converting enzyme (ACE), thereby lowering the production of angiotensin II and decreasing the breakdown of bradykinin. The decrease in angiotensin II results in relaxation of arteriole smooth muscle leading to a decrease in total peripheral resistance, reducing blood pressure as the blood is pumped through widened vessels. Its effect on bradykinin is responsible for the dry cough side effect.
  Ramipril, a prodrug or precursor drug, is converted to the active metabolite ramiprilat by carboxylesterase 1. Ramiprilat is mostly excreted by the kidneys. Its half-life is variable (3–16 hours), and is prolonged by heart and liver failure, as well as kidney failure.
caption: Ramipril 1.25-mg oral capsule, 
  letter codes and icons may differ
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