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Important information about ramipril

Do not use ramipril if you are pregnant. Stop using ramipril and tell your doctor right away if you become pregnant. Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of ramipril. Do not use salt substitutes or potassium supplements while taking ramipril, unless your doctor has told you to.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking ramipril, which can lead to severely low blood pressure or a serious electrolyte imbalance.

Your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using ramipril. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using ramipril even if you feel fine. High blood pressure often has no symptoms.

Before taking ramipril

You should not use this medication if you are allergic to ramipril or to any other ACE inhibitor, such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), or trandolapril (Mavik).

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use ramipril:

• kidney disease (or if you are on dialysis);

• liver disease;

• diabetes;

• a connective tissue disease such as Marfan syndrome, Sjogren’s syndrome, lupus, scleroderma, or rheumatoid arthritis;

• if you are also taking telmisartan (Micardis); or

• if you have ever had a severe allergic reaction.

FDA pregnancy category D. Do not use ramipril if you are pregnant. Stop using this medication and tell your doctor right away if you become pregnant. Ramipril can cause injury or death to the unborn baby if you take the medicine during your second or third trimester. Use effective birth control while taking this medicine. Ramipril can pass into breast milk and may harm a nursing baby. You should not breast-feed while taking ramipril.

How should I take ramipril?

Take ramipril exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Ramipril can be taken with or without food.

Swallow the ramipril tablet whole.

You may open the ramipril capsule and sprinkle the medicine into a half-cup (4 ounces) of water, apple juice, or applesauce to make swallowing easier. Swallow without chewing. You may store the mixture for up to 24 hours at room temperature, or up to 48 hours in a refrigerator.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking ramipril, which can lead to severely low blood pressure or a serious electrolyte imbalance.

To be sure ramipril is helping your condition, your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using ramipril. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using ramipril even if you feel fine. High blood pressure often has no symptoms.

Store ramipril at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include feeling extremely dizzy or light-headed, or fainting.

What should I avoid while taking ramipril?

Avoid drinking alcohol. It can further lower your blood pressure and may increase some of the side effects of ramipril. Do not use salt substitutes or potassium supplements while taking ramipril, unless your doctor has told you to.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Ramipril side effects

Get emergency medical help if you have any of these signs of an allergic reaction to ramipril: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• feeling like you might pass out;

• dry mouth, thirst, confusion, swelling, and urinating less than usual or not at all;

• fever, chills, body aches, flu symptoms, sores in your mouth and throat;

• easy bruising or bleeding;

• pale skin, dark colored urine, fever, confusion or weakness.

• jaundice (yellowing of the skin or eyes); or

• chest pain.

Less serious ramipril side effects may include:

• cough;

• tired feeling, headache;

• dizziness, spinning sensation; or

• nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ramipril?

Tell your doctor about all other medicines you use, especially:

• a diuretic (water pill);

• gold injections to treat arthritis;

• lithium (Lithobid, Eskalith);

• a potassium supplement such as K-Dur, Klor-Con;

• salt substitutes that contain potassium; or

• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), and others.

This list is not complete and other drugs may interact with ramipril. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.