Altace

Generic name: Ramipril

Drug class: Angiotensin Converting Enzyme (ACE) Inhibitors

Dosage form: Capsules (1.25 mg, 2.5 mg, 5 mg, 10 mg)

Root of administration: Oral

Dose:

• Hypertension: Initial dose: 2.5 mg once daily; Maintenance dose: 2.5–20 mg daily, administered as a single dose or in two equally divided doses. If blood pressure is not controlled with ramipril alone, a diuretic can be added.
• Reduction in Risk of Myocardial Infarction, Stroke, and Death from Cardiovascular Causes: Initiate dosing at 2.5 mg once daily for 1 week, 5 mg once daily for the next 3 weeks, and then increase as tolerated to a maintenance dose of 10 mg once daily.
• Heart Failure Post-Myocardial Infarction: Initial dose: 2.5 mg twice daily; Maintenance dose: 5 mg twice daily.

Mechanism of action: Ramipril is an ACE inhibitor that decreases the activity of the renin-angiotensin-aldosterone system by inhibiting the conversion of angiotensin I to angiotensin II, leading to vasodilation and reduced blood pressure.

Drug usage cases:

• Hypertension
• Heart failure post-myocardial infarction
• Reduction in risk of myocardial infarction, stroke, and death from cardiovascular causes
• Diabetic nephropathy

Drug contraindications:

• Hypersensitivity to ramipril or any other ACE inhibitor
• History of angioedema related to previous ACE inhibitor therapy
• Concomitant use with aliskiren in patients with diabetes
• Concomitant use with sacubitril (a neprilysin inhibitor) within 36 hours before or after switching to or from ramipril

Side effects:

• Common: Headache, dizziness, fatigue, cough
• Serious: Angioedema, hyperkalemia, hypotension, renal dysfunction, liver dysfunction, neutropenia, agranulocytosis, and elevated liver enzymes

Warnings:

• Monitor blood pressure regularly during treatment
• Assess renal function before and during therapy
• Discontinue if signs of angioedema occur
• Use caution in patients with a history of renal artery stenosis
• Avoid concomitant use with potassium supplements or potassium-sparing diuretics unless directed by a healthcare provider
• Use caution in patients with a history of collagen vascular disease, such as lupus or scleroderma
• Discontinue if signs of liver dysfunction occur
• Use caution in patients with a history of electrolyte imbalances

Use during pregnancy or breastfeeding: Ramipril is contraindicated during pregnancy due to potential fetal harm. If pregnancy occurs during treatment, discontinue immediately and consult a healthcare provider. Ramipril is also contraindicated during breastfeeding; alternative treatments should be considered.