Ramipril
What is ramipril?
Ramipril is a medication that belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors. It is commonly prescribed to help manage conditions affecting the heart and blood vessels by relaxing blood vessels, reducing blood pressure, and easing the workload on the heart.
What is ramipril used to treat?
Ramipril is used for[1]:
High blood pressure (hypertension)
Heart failure
Reducing the risk of heart attack and stroke
Improving survival in patients with heart failure or reduced heart function after a heart attack
Protecting the kidneys in people with diabetes or proteinuric kidney disease
How does ramipril work?
Ramipril works by blocking a substance in the body (ACE) that causes blood vessels to narrow. This allows the blood vessels to relax and widen. This lowers blood pressure and makes it easier for the heart to pump blood around the body[1].
Who can take ramipril?
Most adults can take ramipril, but it may not be suitable for people who[1]:
Are pregnant or breastfeeding
Have ever had an allergic reaction to Ramipril or other ACE inhibitors.
Have had angioedema (swelling under the skin)
Have diabetes, heart, kidney or liver problems
Always consult a doctor or pharmacist before starting ramipril and always follow the instructions in the Patient Information Leaflet[2].
How do you take ramipril?
Ramipril is available in tablets, capsules, with liquid formulations less commonly prescribed. It is usually taken once or twice a day. It can be taken with or without food[1]. Your doctor will adjust your dose based on your condition, response to treatment, and regular monitoring of blood pressure or kidney function. Follow your doctor’s instructions carefully. Swallow the tablets whole with water. Ramipril capsules can be opened and mixed with water or apple sauce if needed[1].
If you are taking the liquid, it should come with a syringe or spoon designed to hold the correct amount. If you do not have either, ask your pharmacist rather than using a kitchen teaspoon[1].
What is the typical dose of ramipril?
The dose or Ramipril depends on the condition that is being treated[1]:
The usual starting dose is 1.25mg to 2.5mg once daily, which may be adjusted based on your condition and response in regular intervals over a few weeks.
The maximum dose is typically 10 mg per day.
Dosages may be lower for people with kidney problems or those taking diuretics.
Can you stop taking ramipril?
No, you should not stop taking ramipril unless told by your doctor or pharmacist. Treatment is normally long term and may be lifelong. Stopping Ramipril could cause your blood pressure to increase or worsen any heart failure[1].
What do you do if you take too much ramipril?
If you take more than your prescribed dose of ramipril, it could make you feel dizzy, sleepy, and give you palpitations. Call 111 for advice if you have taken more than your prescribed dose of ramipril.
What do you do if you forget to take your ramipril dose?
If you miss a dose, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue with your regular schedule. Never take 2 doses at the same time[1].
What are the side effects of ramipril?
The most common side effects of ramipril include[1][2]:
Dry, persistent cough
Dizziness or lightheadedness
Headache
Fatigue
Nausea
The more serious side effects include[1][2]:
Severe stomach pain
Signs of kidney problems (e.g., changes in urination)
You feel tired, faint or dizzy and you have signs or bleeding, sore throat and high temperature- this could be a sign or blood or bone marrow disorder
If you have a faster heart rate, chest pain and tightness in your chest, or experience a rare allergic reaction (rash, itching, swelling of the face, lips, tongue, or throat), then ring 999 or go to A&E straight away.
If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice.
The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2].
Medicines you can and can’t take with ramipril
Some medicines can interfere with how ramipril works. You must inform your doctor or pharmacist if you take any of these medicines[1][2]:
Diuretics (water pills)
Medicines to treat low blood pressure, asthma or allergies such as ephedrine
Anti-inflammatory medicines like ibuprofen
Potassium supplements or drugs that increase potassium in your blood like spironolactone or trimethoprim.
Lithium
Other ACE inhibitors or other medicines for high blood pressure
Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2].
Frequently asked questions about ramipril
Can I drink alcohol while taking ramipril?
Yes, but alcohol can increase the blood pressure-lowering effect, making you feel dizzy. It is best to avoid alcohol until you know how the medicine will affect you[1].
How long does ramipril take to work?
It depends on what you are taking it for. It starts working within a few hours, but full effects may take a few weeks, or months depending on what you’re taking it for[1].
Can I take ramipril long-term?
Yes, it is often prescribed for long-term use to manage chronic conditions[1].
Is ramipril safe during pregnancy?
No, ramipril is not recommended in pregnancy. If you are already pregnant you should stop taking Ramipril and talk to your doctor or pharmacist straight away[1].
Can I take herbal supplements with ramipril?
Some may interact. Always check with your doctor or pharmacist[1].
For the official NHS guide to ramipril, visit their website.
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The information provided on this Medicines A-Z page is intended for general informational purposes only and was accurate as of June 2025. It is designed to offer simple, patient-friendly summaries of prescribed medications based on publicly available resources, including those from the National Health Service (NHS). This content does not constitute medical advice, diagnosis, or treatment and is not a substitute for professional guidance from a qualified healthcare professional, such as a doctor or pharmacist.
Patients should always consult their healthcare professional before starting, stopping, or changing any prescribed medication, and must inform them of any known allergies, medical conditions, or other medications being taken to ensure safe use. The inclusion of a medication on this page does not guarantee its availability, suitability, or approval for use in all cases, as prescribing decisions are made by healthcare professionals based on individual patient needs.
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