Ramipril is an ACE inhibitor. ACE stands for angiotensin converting enzyme.Ramipril is used to treat high blood pressure (hypertension) or congestive heart failure, and to improve survival after a heart attack.

Brand name

Tritace

Uses

Ramipril is a medicine widely used to treat high blood pressure (hypertension) and heart failure. It's also prescribed after a heart attack.Ramipril helps prevent future strokes, heart attacks and kidney problems.

Pharmacokinetics

Absorption: Ramipril is readily absorbed when taken orally; the maximum plasma concentration in the therapeutic window is typically reached within 1 hour. The bioavailability of ramipril is approximately 50% to 60%. Although meals do not significantly impact the extent of absorption of ramipril, taking the drug with food can slow down the absorption rate.

Metabolism: Removing the ester group from ramipril forms its active metabolite, ramiprilat. Additionally, the glucuronidation of both ramipril and ramiprilat produces inactive metabolites. Notably, ramipril is not a substrate, inhibitor, or inducer of cytochrome P450 enzymes.

Ramipril is primarily excreted through urine (60%) and stool (40%). In patients with a creatinine clearance (CrCl) of less than 40 mL/min/1.73 m2, the peak plasma concentration of ramiprilat is twice as high as those without kidney disorders. Similarly, the trough level tends to increase 5 times, and the area under the curve (AUC), representing drug exposure, is elevated 3- to 4-fold in these patients. Patients with liver impairment, which affects ramipril metabolism, may experience an increase in plasma levels by approximately 3-fold.

Adverse Effects

Comman side effects

>10%

Cough (7-8%)

Hypotension (2-11%)

1-10%

Headache (1-5%)

Angina pectoris (3%)

Dizziness (2-4%)

Nausea (2%)

Vomiting (2%)

Postural hypotension (2%)

Syncope (2%)

Vertigo (2%)

Abnormal kidney function (1%)

Diarrhea (1%)

<1%

Angioedema (0.3%)