ramipril
Brand names: Altace
Ramipril is a medicine that lowers blood pressure. It can also help people with heart failure after a heart attack.
Drug Pricing (NADAC)
Brand Price
$7.43/unit
Generic Price
$0.09/unit
Generic Savings
99%
Generic Available
Yes (6 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Ramipril is used to treat high blood pressure.
Common side effects
Headache, Dizziness, Fatigue
Key warnings
This drug can cause serious harm or death to an unborn baby.
How It Works
Ramipril belongs to a class of drugs called ACE inhibitors. It works by blocking a substance in your body that tightens blood vessels. This helps your blood vessels relax and lowers your blood pressure.
How to Take It
For high blood pressure, the starting dose is usually 2.5 mg to 20 mg once a day. Your doctor may change your dose every 2 to 4 weeks based on your blood pressure. For heart failure after a heart attack, the starting dose is 2.5 mg twice a day. You can swallow the capsule whole, or open it and mix the contents with applesauce, water, or apple juice.
Pregnancy & Breastfeeding
Do not take ramipril if you are pregnant. It can harm your unborn baby. It is not recommended to use ramipril if you are breastfeeding.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store ramipril capsules at room temperature, away from light and moisture.
Side Effects (from patient reports)
Based on 66,606 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 119,507 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.
Total Reports
119,507
Death-Related Reports
12,637
Hospitalization Reports
62,948
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DYSPNOEA | 8,083 |
| 2 | FATIGUE | 7,877 |
| 3 | NAUSEA | 7,339 |
| 4 | DIARRHOEA | 6,913 |
| 5 | DIZZINESS | 6,526 |
| 6 | OFF LABEL USE | 6,516 |
| 7 | DRUG INEFFECTIVE | 6,279 |
| 8 | VOMITING | 6,055 |
| 9 | PAIN | 5,656 |
| 10 | HEADACHE | 5,363 |
| 11 | ACUTE KIDNEY INJURY | 5,292 |
| 12 | GENERAL PHYSICAL HEALTH DETERIORATION | 5,162 |
| 13 | ASTHENIA | 5,044 |
| 14 | MALAISE | 4,937 |
| 15 | ARTHRALGIA | 4,915 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
This drug can cause serious harm or death to an unborn baby. If you are pregnant or plan to become pregnant, tell your doctor right away. Stop taking ramipril as soon as you know you are pregnant.
Known Drug Interactions
Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) or potassium supplements can increase the risk of hyperkalemia.
Mechanism: Both of these medicines can cause your body to hold onto potassium, which may lead to dangerously high potassium levels in your blood.
What to do: Your doctor should monitor your blood potassium levels closely while you are taking both medications.
In a large-scale, long-term clinical efficacy study, the combination of telmisartan and ramipril resulted in an increased incidence of clinically important renal dysfunction (death, doubling of serum creatinine, dialysis) compared with groups receiving either drug alone. Therefore, concomitant use of telmisartan and ramipril is not recommended [see Dual Blockade of the Renin-Angiotensin-Aldosterone System ( 5.7 ) ].
Mechanism: Taking these two types of blood pressure medicines together can put too much stress on your kidneys and increase the risk of kidney damage.
What to do: This combination is not recommended and you should talk to your doctor about using a different treatment.
• Lithium: Use with caution ( 7.3 ). 7.3 Lithium Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors during therapy with lithium; therefore, frequent monitoring of serum lithium levels is recommended. If a diuretic is also used, the risk of lithium toxicity may be increased.
Mechanism: Ramipril can make it harder for your kidneys to remove lithium from your body, which can cause lithium to reach toxic levels.
What to do: Your doctor should check your lithium blood levels frequently to make sure they stay in a safe range.
Potassium-sparing diuretics (spironolactone, amiloride, triamterene, and others) or potassium supplements can increase the risk of hyperkalemia.
Mechanism: Both of these drugs cause your body to hold onto potassium instead of getting rid of it through your urine. This can lead to a dangerous buildup of potassium in your blood.
What to do: Your doctor should monitor your blood potassium levels closely if you take these together. They may need to adjust your doses or change your treatment.
7.6 Other Neither ramipril nor its metabolites have been found to interact with food, digoxin, antacid, furosemide, cimetidine, indomethacin, and simvastatin.
Mechanism: These two medicines do not have any known effect on how the other one works or is processed.
What to do: No special monitoring or dosage changes are required when taking these drugs together.
Common Questions
Can I take ramipril with other medications?
What should I avoid while taking ramipril?
How long does it take for ramipril to work?
Can I stop taking ramipril if I feel better?
Does ramipril have any effect on my kidneys?
Can ramipril cause angioedema?
Can I drink alcohol while taking ramipril?
What if I have diarrhea or vomiting while taking ramipril?
Can ramipril cause a cough?
Are there any long-term side effects of ramipril?
What are the common side effects of ramipril?
Does ramipril interact with other medications?
What drug class is ramipril?
Is there a generic version of ramipril?
Is ramipril safe during pregnancy?
Has ramipril been recalled?
Active Recalls
Labeling: Incorrect or Missing Lot And/or Exp Date: Bottles labeled with the incorrect expiration date of 03/18 rather than 09/17.
Actavis Laboratories, FL, Inc.
Related Medications in ACE Inhibitor
Other drugs grouped near ramipril — same-class peers and common alternatives.
acebutolol
Sectral
Acebutolol is a medicine that helps lower blood pressure and control irregular heartbeats.
Compare with ramipril →
aliskiren
Tekturna
Tekturna is a medicine used to treat high blood pressure.
Compare with ramipril →
amiloride
Midamor
Amiloride is a water pill that helps your body hold onto potassium.
Compare with ramipril →
amlodipine
Norvasc
Amlodipine (Norvasc) is a drug that lowers blood pressure and treats chest pain.
Compare with ramipril →
amlodipine/benazepril
Lotrel
Lotrel is a combination medicine that contains amlodipine and benazepril.
Compare with ramipril →
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for ramipril
The FDA label for ramipril (sold under brand names such as Altace) classifies it as a prescription-only medication in the ACE Inhibitor class. Ramipril is used to treat high blood pressure. Official labeling lists 4 commonly reported side effects, including Headache, Dizziness, Fatigue.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 66,606 voluntary reports. The database also lists 11 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.09 versus $7.43 for the brand — a 99% generic savings.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 1 recall record on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: July 1, 2022
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages