How to use
Ramipril should be taken orally once a day with a full glass of water. It can be taken with or without food. Take Ramipril at approximately the same time every day to maintain an even level of the drug in your blood.
Take Ramipril exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication.
While you are taking Ramipril, you could experience vomiting, diarrhea or heavy sweating and this can cause you to become dehydrated. That can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking Ramipril. Drink plenty of water each day while you are taking this medication.

Overdose

Symptoms of a Ramipril overdose may include feeling extremely dizzy or light-headed or fainting. Seek emergency medical attention if you think you have used too much of this medicine.

Missed dose

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

Notes

Avoid drinking alcohol while taking Ramipril. It can further lower your blood pressure and may increase some of the side effects of Ramipril.
Do not use salt substitutes or potassium supplements while taking Ramipril, unless your doctor has told you to.
Do not share this medication with others, as they may have a problem that is not effectively treated by this drug.

Storage

Store Ramipril between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. KEEP THIS AND ALL OTHER MEDICATIONS OUT OF REACH OF CHILDREN.

Important note

The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed that the taking of this medication is safe, appropriate or effective for you.

* Illustrations are for graphic purposes only and the ordered medication may differ in appearance.

Precautions

You should not use this medication if you are allergic to Ramipril or to any other ACE inhibitor, such as:

• Benazepril (Lotensin)
• Captopril (Capoten)
• Fosinopril (Monopril)
• Enalapril (Vasotec)
• Lisinopril (Prinivil, Zestril)
• Moexipril (Univasc)
• Perindopril (Aceon)
• Quinapril (Accupril)
• Trandolapril (Mavik)

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use Ramipril:

• A connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis
• If you have ever had a severe allergic reaction
• A history of heart problems (eg, aortic stenosis, heart failure), blood vessel problems, blood flow problems, bone marrow problems, kidney problems, certain liver problems (eg, ascites, cirrhosis) or diabetes
• A history of angioedema, stroke or recent heart attack or you have had a kidney transplant
• An autoimmune disease (eg, lupus, rheumatoid arthritis, scleroderma)
• Dehydration or have low blood volume, high blood potassium levels or low blood sodium levels or if you are on a low-salt (sodium) diet
• If you are receiving treatments to reduce sensitivity to bee stings
• If you are on dialysis or are scheduled to have major surgery

Ramipril is classed by the FDA as pregnancy category D. Do not use this medication without telling your doctor if you are pregnant or planning a pregnancy. Ramipril could cause birth defects in the baby if you take the medication during pregnancy. Stop using this medication and tell your doctor right away if you become pregnant during treatment. Ramipril can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Drug interactions

Before taking Ramipril, tell your doctor if you are taking any of the following drugs:

• A diuretic (water pill)
• Gold injections to treat arthritis
• Lithium (Lithobid, Eskalith)
• A potassium supplement such as K-Dur, Klor-Con
• Salt substitutes that contain potassium
• Aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn) and others

If you are using any of these drugs, you may not be able to use Ramipril or you may need dosage adjustments or special tests during treatment.

This list is not complete and other drugs may interact with Ramipril. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Get emergency medical help if you have any of these signs of an allergic reaction to Ramipril:

• Hives
• Severe stomach pain
• Difficulty breathing
• Swelling of the  face, lips, tongue, or throat

Call your doctor at once if you have any of these serious side effects:

• Feeling light-headed, fainting
• Urinating less than usual, or not at all
• Fever, chills, body aches, flu symptoms
• Pale skin, easy bruising or bleeding, unusual weakness
• Pounding or uneven heartbeats
• Slow heart rate, weak pulse, muscle weakness, tingly feeling
• Jaundice (yellowing of the skin or eyes)
• Chest pain
• Swelling, rapid weight gain

Less serious Ramipril side effects may include:

• Cough
• Dizziness, drowsiness, headache
• Sleep problems (insomnia)
• Decreased sex drive, impotence or difficulty having an orgasm
• Nausea, vomiting
• Mild skin itching or rash

Notify your doctor if any other side effects occur, especially if they are specifically bothersome.