Ramipril is an ACE inhibitor, used for blood pressure, heart failure and to protect the kidneys in diabetes. Two things are worth knowing before you start: it commonly causes a dry cough, and there are days when you should temporarily stop taking it.
High blood pressure, heart failure, protection of the kidneys in people with diabetes or kidney disease, and reducing cardiovascular risk after a heart attack.
Usually once daily. The first dose is often taken at bedtime, because it can cause dizziness — after that, take it at the same time each day.
You will normally have a blood test to check kidney function and potassium a week or two after starting or increasing the dose. Do attend it; it is not a formality.
Get up slowly from sitting or lying, particularly in the first few days.
Around one in ten people develop a persistent dry, tickly cough on an ACE inhibitor. It is not dangerous but it can be genuinely irritating, and it does not respond to cough medicine.
It is not a reason to suffer in silence. There is a closely related group of medicines — the sartans, such as losartan — that work similarly without the cough, and switching is straightforward. Tell your GP.
Dizziness, headache and tiredness are common early on and often settle. Ramipril can raise potassium levels, which is one reason for the blood tests.
Get urgent help for swelling of the face, lips, tongue or throat, or difficulty breathing or swallowing — a rare reaction called angioedema that needs immediate attention.
Avoid potassium-based salt substitutes. Tell your prescriber about anti-inflammatories such as ibuprofen, lithium, and potassium supplements.
ACE inhibitors must not be taken in pregnancy. If you are pregnant or planning a pregnancy, speak to your GP promptly about switching.
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