Ramipril
Rx Only
Generic NameRamipril
Therapeutic ClassACE Inhibitor
Common Dose2.5–10 mg daily
Max / 24h20 mg
PregnancyCategory D
Indications ▼
Hypertension (primary and secondary)
Heart failure management
Post-myocardial infarction with heart failure
Reduction of cardiovascular events in high-risk patients
Diabetic and non-diabetic nephropathy (renal protection)
Mechanism & Pharmacokinetics ▼
Mechanism: Inhibits angiotensin-converting enzyme, reducing formation of angiotensin II, leading to vasodilation and decreased aldosterone secretion.
Cardiac Effect: Reduces preload and afterload, improves ventricular remodeling.
Pharmacokinetics: Prodrug converted to active ramiprilat; peak 2–4 hours; half-life 13–17 hours; primarily renal excretion.
Dosage & Administration ▼
| Patient Category | Recommended Dose | Max / 24h |
|---|---|---|
| Adults (Hypertension) | 2.5–10 mg orally once daily | 20 mg |
| Adults (Heart Failure / Post-MI) | 1.25–5 mg orally 1–2 times daily | 20 mg |
| Elderly | Start with lower dose; adjust based on blood pressure and renal function | 20 mg |
| Renal Impairment | Reduce dose; monitor serum creatinine and potassium | 20 mg |
Note: Take at the same time each day. Swallow whole with water. Monitor blood pressure, kidney function, and electrolytes regularly.
Side Effects ▼
Common: Dry cough, dizziness, hypotension
Occasional: Hyperkalemia, fatigue, headache
Rare: Angioedema, renal impairment, severe hypotension
Contraindications ▼
History of angioedema related to ACE inhibitors
Pregnancy (especially 2nd and 3rd trimester)
Bilateral renal artery stenosis
Drug Interaction ▼
Potassium supplements or potassium-sparing diuretics increase hyperkalemia risk
NSAIDs may reduce antihypertensive effect
Lithium toxicity risk increased
Pregnancy & Lactation ▼
Pregnancy Category D; contraindicated especially in later trimesters
Use during breastfeeding only if clearly necessary
Clinical / Research Summary ▼
Proven to reduce cardiovascular mortality in high-risk patients.
Improves survival in heart failure and post-MI patients.
Provides renal protection in diabetic nephropathy.
Long half-life supports once-daily dosing in most patients.
Patient Counseling Points ▼
Take at the same time daily.
Rise slowly to prevent dizziness.
Report persistent dry cough or swelling of face/lips.
Regular blood pressure and kidney function monitoring required.
Storage & Handling ▼
Store below 25°C.
Protect from moisture and light.
Brand Names (Bangladesh & Global) ▼
Bangladesh:
Acecard® 1.25 mg
Acecard® 2.5 mg
Acecard® 5 mg
Aceril® 2.5 mg
Aceril® 5 mg
G-Ramipril® 2.5 mg
G-Ramipril® 5 mg
Ramilon® 2.5 mg
Ramilon® 5 mg
Ramipress® 1.25 mg
Ramipress® 2.5 mg
Ramipress® 5 mg
Ramoril® 1.25 mg
Ramoril® 2.5 mg
Ramoril® 5 mg
Ripril® 2.5 mg
Ripril® 5 mg
Ramipro® 2.5 mg
Ramipro® 5 mg
Ramil® 2.5 mg
Ramil® 5 mg
Global:
Acecard® 1.25 mg
Medical Disclaimer: This information is for educational purposes only. Consult a qualified healthcare professional for diagnosis and treatment.
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