R R

What Is Ramipril?

Ramipril is a prescription angiotensin-converting enzyme, or ACE, inhibitor used to treat hypertension and reduce certain cardiovascular risks. It is also approved for treatment of selected patients with heart failure following a heart attack. Ramipril is available as oral capsules and is associated with the brand name Altace. It reduces the effects of a hormone system that regulates blood vessel constriction and fluid balance. Ramipril can help lower blood pressure and reduce cardiovascular complications in eligible patients. It carries a boxed warning for fetal toxicity and must not be used during pregnancy.

Link to This Resource Page

Provide a valuable resource to your clients or customers by linking to this resource page. Just place the following link on your website.

To display this...

What Is Ramipril?

Ramipril is a prescription angiotensin-converting enzyme, or ACE, inhibitor used to treat hypertension and reduce certain cardiovascular risks. It is also approved for treatment of selected patients with heart failure following a heart attack. Ramipril is available as oral capsules and is associated with the brand name Altace. It reduces the effects of a hormone system that regulates blood vessel constriction and fluid balance. Ramipril can help lower blood pressure and reduce cardiovascular complications in eligible patients. It carries a boxed warning for fetal toxicity and must not be used during pregnancy.

read more about ramipril ...

Copy this HTML:

Copy HTML Copied!

How Does Ramipril Work?

Ramipril is converted in the body to ramiprilat, its active metabolite, which inhibits angiotensin-converting enzyme. This reduces the formation of angiotensin II, a substance that constricts blood vessels and stimulates aldosterone secretion. Lower angiotensin II activity allows blood vessels to relax and reduces certain effects of sodium and fluid retention. These actions help lower blood pressure and reduce workload on the heart. ACE inhibition also increases bradykinin activity, which may contribute to dry cough and angioedema. Ramipril helps manage cardiovascular risk but does not cure the underlying conditions.

What Conditions Does Ramipril Treat?

Ramipril is approved for hypertension and may be prescribed alone or with thiazide diuretics. It is also approved to reduce the risk of heart attack, stroke, or cardiovascular death in patients aged 55 years and older who have specified cardiovascular disease or diabetes with additional risk factors. Another indication is treatment of clinically stable patients who develop signs of congestive heart failure within the first few days after an acute heart attack. A clinician considers blood pressure, kidney function, potassium levels, heart failure status, and other medications before prescribing ramipril.

How Should Ramipril Be Taken?

Ramipril is taken orally according to an individualized dosing schedule. Adults beginning hypertension treatment without a diuretic commonly start at 2.5 mg once daily, with usual maintenance doses ranging from 2.5 mg to 20 mg daily. For cardiovascular risk reduction in eligible adults, treatment commonly begins at 2.5 mg daily for one week, increases to 5 mg daily for three weeks, and then reaches 10 mg daily if tolerated. Patients with heart failure after a heart attack commonly begin at 2.5 mg twice daily. Kidney impairment and other medications may require dosage adjustments. Blood pressure, kidney function, and potassium levels should be monitored.

What Are the Side Effects and Warnings of Ramipril?

Common adverse effects include dizziness, headache, fatigue, cough, and low blood pressure. Serious risks include angioedema, kidney impairment, elevated potassium levels, and significant hypotension. Ramipril carries a boxed warning for fetal toxicity because medications affecting the renin-angiotensin system can injure or kill a developing fetus. It must not be combined with sacubitril-containing medications, and a 36-hour separation is required when switching between these treatments. Ramipril is contraindicated in patients with certain histories of angioedema. Facial or tongue swelling, difficulty breathing, fainting, or reduced urination requires immediate medical assessment.

Common Questions About Ramipril

Is ramipril the same as Altace?

Yes. Altace is a brand name for ramipril, an ACE inhibitor prescribed for hypertension and specified cardiovascular conditions.

Can ramipril lower the risk of heart attack or stroke?

Yes. Ramipril is approved to reduce heart attack, stroke, and cardiovascular death risk in certain patients aged 55 years and older with established risk factors.

Can ramipril cause a dry cough?

Yes. ACE inhibitors such as ramipril can cause a persistent dry cough. Patients should discuss troublesome symptoms with their clinician.

Is ramipril safe during pregnancy?

No. Ramipril carries a boxed warning for fetal toxicity. Patients who become pregnant should contact their healthcare professional immediately.

References

DailyMed - ALTACE (ramipril) capsule. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0fc34cd8-86e6-4034-73bd-4263a68ba046. Date Accessed November 3, 2026.

Ramipril. LiverTox. https://www.ncbi.nlm.nih.gov/books/NBK548689/. Date Accessed November 3, 2026.

Ramipril. MedlinePlus. https://medlineplus.gov/druginfo/meds/a692027.html. Date Accessed November 3, 2026.

Ramipril. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Ramipril. Date Accessed November 3, 2026.

Ramipril. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK537119/. Date Accessed November 3, 2026.