View source for Ramipril detailed information

{{drugbox
| IUPAC_name = (1''S'',5''S'',7''S'')-8-[(2''S'')-2-<nowiki>[[</nowiki>(1''S'')-1-ethoxycarbonyl-3-phenyl-<br>propyl]amino]propanoyl]-8-azabicyclo[3.3.0]octane-7-<br>carboxylic acid
| image = Ramipril_svg.png
| CAS_number = 87333-19-5
| ATC_prefix = C09
| ATC_suffix = AA05
| ATC_supplemental = 
| PubChem = 5362129
| DrugBank = APRD00009
| C = 23 | H = 32 | N = 2 | O = 5
| molecular_weight = 416.511 g/mol
| bioavailability = 28%
| protein_bound = 73% (ramipril)<br>56% (ramiprilat)
| metabolism = [[Liver|Hepatic]], to ramiprilat
| elimination_half-life = 2 to 4 hours
| excretion = [[Kidney|Renal]] (60%) and fecal (40%)
| pregnancy_category = D
| legal_UK = POM
| legal_US = Rx-only
| routes_of_administration = Oral
}}
{{CMG}}



==[[Ramipril (patient information)|For patient information, click here]]==

==Overview==
'''Ramipril''' (marketed as '''Tritace/Ramace''' or '''Altace''') is an [[ACE inhibitor|angiotensin-converting enzyme (ACE) inhibitor]], used to treat [[hypertension]] and [[congestive heart failure]]. ACE inhibitors lower the production of [[angiotensin II]], therefore relaxing arterial muscles while at the same time enlarging the [[arteries]], allowing the [[heart]] to pump [[blood]] more easily, and increasing [[blood flow]] due to more blood being pumped into and through larger passageways.

Ramipril is a [[prodrug]] and is converted to the active [[metabolite]] ramiprilat by [[liver]] [[esterase]] [[enzyme]]s. Ramiprilat is mostly [[excretion|excreted]] by the [[kidney]]s. The [[half-life]] of ramiprilat is variable (3-16 hours), and is prolonged by heart and [[liver failure]], as well as [[renal failure|kidney failure]].

==Indications==
Indications for its use include:
*Mild to moderate [[hypertension]];
*[[Congestive heart failure]];
*Following [[myocardial infarction]] in patients with clinical evidence of [[heart failure]];
*Susceptible patients over 55 years: prevention of myocardial infarction, [[stroke]], cardiovascular death or need of [[revascularization]] procedures.
*Also ramipril has been known to be abused as a downer

==Cautions==
*Do not take potassium supplements without seeking medical advice.
*Do not take during pregnancy

==Contraindications==
Renovascular disease, severe renal impairment (especially in patients with one kidney or with bilateral [[renal artery stenosis]]), volume-depleted patients, history of angioedema while on an ACE inhibitor, pregnancy, hypotension.

==Side-effects==
*may cause swelling of the mouth, tongue, or throat
*low blood sugar in patients taking other medicine for diabetes which shows as sweating or shakiness
*persistent dry cough, dizziness, and light-headedness due to low blood pressure. 

==Dose==
*2.5 to 20 mg per day
*initial dose of 1.25mg per day

==See also==
*[[Hypertension]]
*[[Heart failure]]

==External links==
*[http://www.altace.com Altace (ramipril)], a registered trademark of [[King Pharmaceuticals]], Inc.


{{ACE inhibitors}}

[[Category:ACE inhibitors]]
[[Category:Prodrugs]]
[[Category:Drugs]]

[[de:Ramipril]]
[[hr:Ramipril]]

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