Prescription medication · ACE Inhibitor

ramipril

Also sold as Altace. Ramipril is used to treat high blood pressure.

Data updated 2026-05-15

119,507
FDA reportsOften reported
11
InteractionsSeveral interactions
99% less
Generic vs brandHuge savings
1
Recall record

What the data shows

ramipril (Altace) is a prescription ACE Inhibitor, more reported than most tracked drugs (119,507 FDA reports), whose generic costs a fraction of the brand (about 99% less).

Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.

ramipril (Altace) is a prescription ACE Inhibitor. Ramipril is used to treat high blood pressure.

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 →

View Alternatives → Compare with Another Drug → Full Side Effects Report →

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.

The sections below are summarized in plain English from ramipril's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.

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.

Side Effects (from patient reports)

Based on 119,507 FDA adverse event reports.

Most-reported reactions

Adverse reactions in FAERS for ramipril, by number of reports

reports

What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.

Source FDA Adverse Event Reporting System (FAERS) As of 2025

Reports over time

Adverse-event reports filed for ramipril each year to the FDA Adverse Event Reporting System (FAERS).

05,00010,00015,000 200320062009201220152018202120242025 8,578

Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.

Where ramipril sits

ramipril has more FDA adverse-event reports than 88% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.

fewest reports most reports

Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is ramipril; the line is the median (50th percentile).

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

Reports Mentioning Death

12,637

10.6% of reports — not proof of cause

Hospitalization Reports

62,948

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 52,126 (48%)
Male 56,520 (52%)

Age Distribution

0–17 698
18–44 7,865
45–64 29,155
65–74 25,416
75+ 30,902

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
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
16 FALL 4,895
17 HYPERTENSION 4,780

Reactions in Death Reports

DEATH 2,198
GENERAL PHYSICAL HEALTH DETERIORATION 1,724
DIARRHOEA 1,599
VOMITING 1,545
DYSPNOEA 1,520
PNEUMONIA 1,499
NAUSEA 1,459
PAIN 1,433
CONDITION AGGRAVATED 1,371
CONFUSIONAL STATE 1,370

Reactions in Hospitalization Reports

DYSPNOEA 5,486
NAUSEA 4,617
GENERAL PHYSICAL HEALTH DETERIORATION 4,503
VOMITING 4,485
ACUTE KIDNEY INJURY 4,406
DIARRHOEA 4,309
FATIGUE 3,997
FALL 3,942
DIZZINESS 3,897
ASTHENIA 3,631

Source: 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.

moderate telmisartan

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.

moderate lithium

• 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.

moderate amiloride

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.

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.

Check all your medications →

This is a plain-language summary of FDA-label interaction records and does not provide individual medication-combination directions.

Common Questions

Can I take ramipril with other medications?
Talk to your doctor about all the medicines you take, including over-the-counter drugs, vitamins, and herbal products. Some medicines can interact with ramipril.
What should I avoid while taking ramipril?
Avoid using salt substitutes that contain potassium. Your doctor may also advise you to limit your potassium intake.
How long does it take for ramipril to work?
Ramipril starts working within a few hours, but it may take several weeks to see the full effect on your blood pressure.
Can I stop taking ramipril if I feel better?
Do not stop taking ramipril without talking to your doctor first. Your blood pressure may increase if you stop taking it suddenly.
Does ramipril have any effect on my kidneys?
Ramipril can affect your kidneys, especially if you have kidney problems. Your doctor will monitor your kidney function while you are taking this medicine.
Can ramipril cause angioedema?
Yes, ramipril can cause angioedema, a serious allergic reaction that can cause swelling of the face, tongue, or throat. If you experience these symptoms, stop taking ramipril and seek medical attention immediately.
Can I drink alcohol while taking ramipril?
Talk to your doctor about drinking alcohol while taking ramipril. Alcohol can lower your blood pressure and may increase the risk of side effects.
What if I have diarrhea or vomiting while taking ramipril?
Tell your doctor if you have diarrhea or vomiting. You may become dehydrated, which can lower your blood pressure too much.
Can ramipril cause a cough?
Yes, ramipril can cause a dry cough. If you develop a cough that bothers you, talk to your doctor.
Are there any long-term side effects of ramipril?
Your doctor will monitor you for any long-term side effects while you are taking ramipril.
What are the common side effects of ramipril?
The registry lists Headache, Dizziness, Fatigue, Cough among the most-reported FAERS reaction terms for ramipril. The compiled record contains 119,507 FDA adverse-event reports. These counts are not an individual symptom assessment.
Does ramipril interact with other medications?
The registry has 11 documented interaction rows for ramipril. Notable source-record pairings include spironolactone, telmisartan, lithium. These rows are not a complete medication review.
What drug class is ramipril?
ramipril belongs to the ACE Inhibitor drug class. It requires a prescription (Rx). Ramipril is used to treat high blood pressure.
Is there a generic version of ramipril?
Yes, generic ramipril is available from 6 manufacturers. The generic costs $0.09 per unit compared to $7.43 for the brand version, saving approximately 99%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
What pregnancy or breastfeeding source fields are listed for ramipril?
The FDA label for ramipril contains product-specific pregnancy or breastfeeding language. PlainMeds does not apply that source text to an individual.
Has ramipril been recalled?
There is 1 recall associated with ramipril products. Labeling: Incorrect or Missing Lot And/or Exp Date: Bottles labeled with the incorrect expiration date of 03/18 rather than 09/17. Check the recalls section below for full details and affected products.

Active Recalls

Class III August 30, 2016

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.

Other drugs grouped near ramipril - same-class peers and common alternatives.

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Compare beyond drug class

Nationwide peers by FAERS volume & death-report share

Two PlainMeds-derived comparison paths for ramipril: nearest FDA FAERS report volume and nearest death-report share among drugs with at least 1,000 logged reports, excluding same-class neighbors listed above. Counts reflect reporting volume, not proven individual harm.

Medication Guides

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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 119,507 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 are separate source-record fields. This page is a public FDA/CMS registry and does not provide medical, treatment, substitution, or medication-change directions.

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. This registry does not provide medication decisions.

Last updated: July 1, 2022

PlainMeds is rendered directly from FDA openFDA/FAERS extracts, DailyMed labels, and CMS drug-pricing files, no number is typed in by an editor. FAERS counts, recalls, shortages, and price figures on this page are queried live from those federal extracts. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of 2026-05-15. Primary sources: openFDA / FAERS, DailyMed and CMS Part B ASP.

Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled from the source snapshot dated . See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a data issue.

All federal data sources used on this page