Ramipril is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Ramipril is also used to improve survival after a heart attack. It may also be used in high risk patients (such as patients with heart disease/diabetes) to help prevent heart attacks and strokes. This medication may also be used to treat heart failure in patients who have had a recent heart attack.

Ramipril is an ACE inhibitor and works by relaxing blood vessels so that blood can flow more easily.

Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily.

The dosage is based on your medical condition and response to treatment.

To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

For the treatment of high blood pressure, it may take several weeks before you get the full benefit of this medication. Tell your doctor if your condition does not improve or if it worsens (such as your blood pressure readings remain high or increase).

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 Altace. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

If you need surgery, tell the surgeon ahead of time that you are using ramipril.

Do not Altace use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away.

You should not use Altace if you have ever had angioedema. Do not take ramipril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use ramipril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking ramipril with aliskiren if you have kidney disease.

To make sure Altace is safe for you, tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);
• an electrolyte imbalance (such as high levels of potassium in your blood);
• liver disease;
• a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis;
• if you are on a low-salt diet; or
• if you are also taking telmisartan (Micardis).

Do not use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. Altace can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breast-feed while you are using ramipril.

Altace is not approved for use by anyone younger than 18 years old.

Dizziness, lightheadedness, or tiredness may occur as your body adjusts to the medication. Dry cough may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat).

Although ramipril may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Your doctor will check your kidney function while you are taking ramipril. Tell your doctor right away if you have any signs of kidney problems such as a change in the amount of urine.

This drug may rarely cause serious (possibly fatal) liver problems. Tell your doctor right away if you notice any of the following rare but serious side effects: yellowing eyes/skin, dark urine, severe stomach/abdominal pain, persistent nausea/vomiting.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

How should I use this medicine?

Take this medicine by mouth with a drink of water. Follow the directions on your prescription label. You may take this medicine with or without food. Take your medicine at regular intervals. Do not take more medicine than directed. Do not stop taking your medicine unless your doctor tells you to.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular check ups. Check your blood pressure as directed. Ask your doctor what your blood pressure should be, and when you should contact him or her. If you are diabetic, check your blood sugar as directed.

Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more information.

Check with your doctor if you have severe diarrhea or vomiting, or if you sweat a lot or become dehydrated. The loss of body fluids can be dangerous while taking this medicine.

A few patients have had strong allergic reactions during desensitization treatment with hymenoptera venom and during some kinds of dialysis. Talk to your doctor if you are going to have either of these procedures.

If you are going to have surgery, tell your doctor or health care professional that you are taking this medicine.