What is ramipril?

Ramipril is used to lower high blood pressure. It can also be used to treat heart failure and after having a heart attack. It’s part of a group of drugs called ACE inhibitors - ACE stands for Angiotensin Converting Enzyme.

What is ramipril used for?

Ramipril lowers your blood pressure by blocking one of the body’s processes that can lead to a build-up of a naturally-occurring substance called (angiotensin II) that makes your arteries get tighter and smaller which leads to higher blood pressure.

How do I take ramipril?

Ramipril is usually a capsule or tablet that you take once a day when used for treating high blood pressure. The effect on lowering your blood pressure can be very strong the first time you take it, so it’s often recommended to have this first dose at night, just before you lie down – as it can make you feel very dizzy. Your body will normally adjust to this from about the second or third time you take it so you can switch to taking it in the morning at that stage.

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Ramipril common side effects

Most people taking ramipril feel fine while they are taking it. You may experience some of these side effects, but often they subside after a few days once your body is used to it. Common side effects include:

• a dry, tickly cough that does not go away
• feeling dizzy or lightheaded, especially when you stand up or sit up quickly (this is more likely to happen when you start taking ramipril or move on to a higher dose)
• headaches
• diarrhoea and being sick (vomiting)
• a mild skin rash
• blurred vision

Other side effects

Stop taking ramipril and call a doctor straight away if you get:

• yellow skin or the whites of your eyes turn yellow - this can be a sign of liver problems
• paleness, feeling tired, faint or dizzy, any sign of bleeding (like bleeding from the gums and bruising more easily), sore throat and fever and getting infections more easily - these can be signs of a blood or bone marrow disorder
• a faster heart rate, chest pain and tightness in your chest - these can be signs of heart problems
• shortness of breath, wheezing and tightening of the chest - these can be signs of lung problems
• severe stomach pain - this can be a sign of an inflamed pancreas
• swollen ankles, blood in your pee or not peeing at all - these can be signs of kidney problems
• weak arms and legs or problems speaking - these can be signs of a stroke

Ramipril and alcohol

Drinking alcohol can increase the blood pressure-lowering effect of ramipril, which can make you feel dizzy or lightheaded.

During the first few days of taking ramipril or after a dose increase, it's best to stop drinking alcohol until you see how the medicine affects you.

If you find ramipril makes you feel dizzy, it's best to stop drinking alcohol.

Want to learn more about ramipril and to see what your daily recommended salt intake actually looks like?

Ramipril and food

For all of us, and especially anyone with high blood pressure, it’s important to watch how much salt you have in the food you eat. This includes salt you add, as well as “hidden salt” that might already be in your food.

There’s advice here about how to control the amount of salt in what you eat. Ideally, it should be under 6g a day – check the info to see what that actually means.

If you’re taking ramipril and want to control your salt intake, don’t switch to substitutes like Lo-Salt as it’s high in potassium. Ramipril and related medicines can lead to a very slight and gradual build-up of potassium in your body. Your doctor will arrange blood tests to check this but it’s also worth going easy on potassium-rich foods like bananas.

Healthy living advice

The NHS has a wealth of information on making sure you have a balanced diet. Check out this link for quick and healthy recipes, meal planning and much more. For more information on high blood pressure, and what you can do to prevent it, check out the NHS website.