Side effects of ramipril

Ramipril Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 20, 2018.

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In Summary

Commonly reported side effects of ramipril include: hypotension and increased cough. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to ramipril: oral capsule

Warning

Oral route (Capsule; Tablet)

When pregnancy is detected, discontinue ramipril as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Along with its needed effects, ramipril may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ramipril:

More common

  • Blurred vision
  • confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • sweating
  • unusual tiredness or weakness

Less common

  • Arm, back, or jaw pain
  • chest pain or discomfort
  • chest tightness or heaviness
  • chills
  • cloudy urine
  • cold sweats
  • decrease in urine output or decrease in urine-concentrating ability
  • diarrhea
  • fainting
  • fast or irregular heartbeat
  • shortness of breath

Rare

  • Seizures
  • unexplained bleeding or bruising

Some side effects of ramipril may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Cough

Less common

  • Nausea
  • vomiting

Rare

  • Feeling of constant movement of self or surroundings
  • muscle pain or stiffness
  • sensation of spinning
  • stomach pain
  • weight loss

For Healthcare Professionals

Applies to ramipril: oral capsule, oral tablet

General

The most common adverse reaction is hypotension.

Cardiovascular

Very common (10% or more): Hypotension (11%)

Common (1% to 10%): Angina pectoris, postural hypotension, orthostatic blood pressure decreased

Rare (less than 0.1%): Vascular stenosis, hypoperfusion, vasculitis

Frequency not reported: Disturbed orthostatic regulation, Raynaud’s phenomenon

Gastrointestinal

Common (1% to 10%): Nausea, vomiting, diarrhea, gastrointestinal inflammation, digestive disturbances, abdominal discomfort, dyspepsia

Rare (less than 0.1%): Glossitis

Frequency not reported: Dysphagia, gastroenteritis, increased salivation, gastric pain, aphthous stomatitis

Other

Common (1% to 10%): Fatigue, asthenia, vertigo, bronchitis, sinusitis, chest pain

Uncommon (0.1% to 1%): Peripheral edema, pyrexia, libido decreased

Rare (less than 0.1%): Conjunctivitis, hearing impaired, tinnitus

Frequency not reported: Hearing loss, edema, malaise, gynecomastia

Respiratory

Common (1% to 10%): Cough, nonproductive tickling cough, cough increased, dyspnea

Uncommon (0.1% to 1%): Bronchospasm, asthma aggravated

Frequency not reported: Eosinophilic pneumonitis, epistaxis, nasal congestion

Psychiatric

Uncommon (0.1% to 1%): Depressed mood, anxiety, nervousness, restlessness, sleep disorder

Rare (less than 0.1%): Confusional state

Frequency not reported: Depression, insomnia, disturbance in attention

Nervous system

Common (1% to 10%): Headache, dizziness, syncope

Uncommon (0.1% to 1%): Paresthesia, dysgeusia, ageusia, somnolence

Rare (less than 0.1%): Tremor, balance disorder

Frequency not reported: Smell disturbance, amnesia, convulsions, neuralgia, neuropathy, cerebral ischemia, ischemic stroke, transient ischemic attack, psychomotor skills impaired, burning sensation, parosmia

Musculoskeletal

Common (1% to 10%): Muscle spasm, myalgia

Uncommon (0.1% to 1%): Arthralgia

Frequency not reported: Arthritis

Dermatologic

Common (1% to 10%): Maculopapular rash

Uncommon (0.1% to 1%): Pruritus, hyperhidrosis

Rare (less than 0.1%): Exfoliative dermatitis, urticaria, onycholysis

Frequency not reported: Purpura, pemphigus, pemphigoid, erythema multiforme, toxic epidermal necrolysis, Stevens Johnson syndrome, sweating increased, alopecia, psoriasis aggravated, dermatitis psoriasiform, lichenoid exanthema, enanthema

Renal

Common (1% to 10%): Abnormal kidney function

Uncommon (0.1% to 1%): Renal impairment, acute renal failure

Metabolic

Common (1% to 10%): Creatinine increased, blood potassium increased

Uncommon (0.1% to 1%): Anorexia, decreased appetite, BUN increased

Frequency not reported: Weight gain, hyponatremia, loss of appetite, uric acid elevated, blood glucose elevated, blood sodium decreased

Postmarketing reports: Hypoglycemia

Genitourinary

Uncommon (0.1% to 1%): Worsening of preexisting proteinuria, urine output increased, transient erectile impotence

Frequency not reported: Proteinuria, impotence

Ocular

Uncommon (0.1% to 1%): Visual disturbance, blurred vision

Hematologic

Uncommon (0.1% to 1%): Eosinophilia, hemoglobin or hematocrit decreased

Rare (less than 0.1%): Neutropenia, agranulocytosis, white blood cell count decreased, red blood cell count decreased, platelet count decreased

Frequency not reported: Pancytopenia, hemolytic anemia, thrombocytopenia, leucopenia, bone marrow failure

Hepatic

Uncommon (0.1% to 1%): Hepatic enzymes increased, conjugated bilirubin increased

Rare (less than 0.1%): Cholestatic jaundice, hepatocellular damage

Frequency not reported: Hepatic failure, hepatitis, jaundice, acute liver failure, hepatocellular damage, cholestatic hepatitis, cytolytic hepatitis, serum bilirubin elevated

Immunologic

Uncommon (0.1% to 1%): Angioneurotic edema, angioedema

Very rare (less than 0.01%): Photosensitivity

Frequency not reported: Anaphylactic reaction, anaphylactoid reaction, apparent hypersensitivity reaction, antinuclear antibody increased

Endocrine

Frequency not reported: Syndrome of inappropriate antidiuretic hormone secretion

1. Cerner Multum, Inc. “Australian Product Information.” O 0

2. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

3. “Product Information. Altace (ramipril).” Hoechst Marion-Roussel Inc, Kansas City, MO.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about ramipril

  • During Pregnancy or Breastfeeding
  • Dosage Information
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  • Drug class: Angiotensin Converting Enzyme Inhibitors
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Consumer resources

  • Ramipril
  • Ramipril (Advanced Reading)

Other brands: Altace

Professional resources

  • Ramipril (AHFS Monograph)
  • … +3 more

Related treatment guides

  • Diabetic Kidney Disease
  • High Blood Pressure
  • Heart Failure
  • Cardiovascular Risk Reduction
  • Heart Attack
  • Left Ventricular Dysfunction

Ramipril

Ramipril is the generic version of the brand-name drug Altace, which is used to treat high blood pressure (hypertension).

Ramipril also reduces the risk of a heart attack, stroke, and death in people age 55 and older and at high risk of a major cardiovascular event.

It also improves survival when a person’s heart is not able to pump enough blood to the body (congestive heart failure) after a heart attack.

Ramipril is in a class of drugs called angiotensin-converting enzyme inhibitors, or ACE inhibitors, which work by keeping blood flowing smoothly throughout the body.

Doctors sometimes prescribe ramipril off-label to treat people with other health conditions, such as kidney issues associated with scleroderma (hardening and thickening of the skin), diabetes, and the genetic disorder Alport syndrome.

The FDA approved Ramipril in 1991, and Pfizer manufactures the drug.

In 2012, the consumer watchdog group Public Citizen petitioned the FDA to add black-box warnings cautioning against the use of three hypertension drugs when used together: ACE inhibitors, including ramipril; angiotensin receptor blockers (ARBs); and aliskiren (Tekturna).

Studies show that the three drugs can combine to cause kidney failure, low blood pressure, and hyperkalemia (elevated blood potassium levels).

However, ramipril doesn’t currently have a black-box warning against its combined use with other hypertension drugs.

Ramipril Warnings

Ramipril carries a black-box warning because the drug may cause harm and death to a developing fetus. Do not take ramipril if you are pregnant or plan on becoming pregnant.

People who are hypersensitive to ACE inhibitors should not use ramipril.

Additionally, people with diabetes or kidney impairments should not take ramipril at the same time as aliskiren (Tekturna).

The use of ACE inhibitors, including ramipril, has been associated with the following health problems:

  • An increased risk of angioedema (swelling under the skin) in people with a prior history of the condition or people taking mTOR inhibitors (a class of anti-cancer medications). Depending on where it occurs, it can cause pain, and difficulty swallowing and breathing.
  • Impaired liver function and failure
  • Impaired kidney function
  • Neutropenia and agranulocytosis (conditions associated with low counts of neutrophils, a type of white blood cell)
  • Hypotension
  • Hyperkalemia

Pregnancy and Ramipril

Ramipril can harm a developing fetus, particularly when taken during the second and third trimesters.

Drugs like ramipril can reduce the kidney function of the unborn baby, as well as cause poor development of the baby’s lungs and bones.

Ramipril is also associated with numerous other problems for newborns, including death. Ramipril should not be taken if you are pregnant or plan on becoming pregnant.

Ramipril is excreted in human breast milk and should not be taken if you are breastfeeding.

Do High Blood Pressure Medications Cause Weight Gain?

High blood pressure medications — like other prescription drugs — cause unwanted side effects. They can leave you feeling tired and restless. Some of them may even interfere with your mental health and your weight.

These are the most common types of medications prescribed to treat high blood pressure, what can happen if you continue to gain weight while on medication, and what you can do about it.

The most common high blood pressure medications

Blood pressure medication | Ronstik/iStock/Getty Images

Doctors usually first prescribe a diuretic to treat high blood pressure. These medications increase urination, which reduces blood volume and removes excess saltfrom the body. It’s especially effective for treating mild hypertension.

However, most people with high blood pressure require a combination of diuretics and beta blockers — especially if diuretics alone don’t reduce blood pressure.

Beta blockers work by opening up blood vessels and regulating your heart rhythm so your blood flows with less pressure through your arteries, lowering your blood pressure. The most commonly prescribed beta blockers used to treat high blood pressure include:

  • Acebutolol (Sectral)
  • Atenolol (Tenormin)
  • Bisoprolol fumarate (Zebeta)
  • Carvedilol (Coreg)
  • Metoprolol tartrate (Lopressor) and metoprolol succinate (Toprol-XL)
  • Nebivolol (Bystolic)
  • Penbutolol sulfate (Levatol)

Doctors also prescribe ACE inhibitors and other medications to treat high blood pressure depending on what’s causing you to remain hypertensive.

Fatigue and weight gain are both common side effects of high blood pressure medications.

Is gaining weight with high blood pressure dangerous?

It can be. Weight gain, overweight, and obesity are associated with an increased risk of high blood pressure and heart disease. The more you weigh, the harder your heart has to work to pump blood through more mass. This increases the rate at which your blood flows, causing a gradual rise in blood pressure.

High blood pressure medications such as beta blockers don’t usually cause more than a few pounds (sometimes up to five) of weight gain, according to Mayo Clinic.

However, continuing to follow an unhealthy diet or neglect exercise while on your medication could cause you to gain more weight. This won’t do much to help you control your blood pressure.

Beta blockers reduce high blood pressure. They aren’t prescribed to help you lose weight.

This is why your doctor’s recommendations for treating high blood pressure usually go beyond remembering to take your medication.

What to do if your medication is making you gain weight

Weight gain | Source: iStock

If you’ve been prescribed a high blood pressure medication that is making you gain weight, it’s unlikely there are other treatment options your doctor can prescribe. Doctors often prescribe beta blockers to treat high blood pressure, for example, when previous treatments don’t work.

However, all medications that treat high blood pressure should always accompany positive lifestyle modifications. These are the habits that can help keep you at a healthy weight despite your medication’s unwanted side effect.

Your doctor and/or dietitian will likely recommend, in addition to taking your medication regularly as prescribed:

  • Following a nutritious diet that excludes excess refined sugar and salt
  • Remaining physically active on a consistent schedule (150+ minutes per week — not all at once!)
  • Practicing good “sleep hygiene”
  • Finding healthy ways to manage stress.

It is possible to lose weight and maintain a healthy weight if you have high blood pressure — even if your medication doesn’t seem to be on your side.

If you have concerns about your weight related to high blood pressure or other medical conditions, bring them up with your health care provider. This is a common struggle with practical solutions that work. They can help you come up with an individualized plan that will work best for you.

Altace Capsules

SIDE EFFECTS

Hypertension

ALTACE (ramipril capsules) has been evaluated for safety in over 4,000 patients with hypertension; of these, 1,230 patients were studied in US controlled trials, and 1,107 were studied in foreign controlled trials. Almost 700 of these patients were treated for at least one year. The overall incidence of reported adverse events was similar in ALTACE (ramipril capsules) and placebo patients. The most frequent clinical side effects (possibly or probably related to study drug) reported by patients receiving ALTACE (ramipril capsules) in US placebo-controlled trials were: headache (5.4%), “dizziness” (2.2%) and fatigue or asthenia (2.0%), but only the last was more common in ALTACE (ramipril capsules) patients than in patients given placebo. Generally, the side effects were mild and transient, and there was no relation to total dosage within the range of 1.25 to 20 mg. Discontinuation of therapy because of a side effect was required in approximately 3% of US patients treated with ALTACE (ramipril capsules) . The most common reasons for discontinuation were: cough (1.0%), “dizziness” (0.5%), and impotence (0.4%). Of observed side effects considered possibly or probably related to study drug that occurred in US placebo-controlled trials in more than 1% of patients treated with ALTACE (ramipril capsules) , only asthenia (fatigue) was more common on Altace (ramipril capsules) than placebo (2% vs. 1%).

PATIENTS IN US PLACEBO CONTROLLED STUDIES

ALTACE Placebo
(n=651) (n=286)
n % n %
Asthenia (Fatigue) 13 2 2 1

In placebo-controlled trials, there was also an excess of upper respiratory infection and flu syndrome in the ramipril group, not attributed at that time to ramipril. As these studies were carried out before the relationship of cough to ACE inhibitors was recognized, some of these events may represent ramipril-induced cough. In a later 1-year study, increased cough was seen in almost 12% of ramipril patients, with about 4% of patients requiring discontinuation of treatment.

Heart Failure Post Myocardial Infarction

Adverse reactions (except laboratory abnormalities) considered possibly/probably related to study drug that occurred in more than one percent of patients and more frequently on ramipril are shown below. The incidences represent the experiences from the AIRE study. The follow-up time was between 6 and 46 months for this study.

Percentage of Patients with Adverse Events Possibly/ Probably Related to Study Drug
Placebo-Controlled (AIRE) Mortality Study

Adverse Event Ramipril Placebo
(n=1004) (n=982)
Hypotension 11 5
Cough Increased 8 4
Dizziness 4 3
Angina Pectoris 3 2
Nausea 2 1
Postural Hypotension 2 1
Syncope 2 1
Vomiting 2 0.5
Vertigo 2 0.7
Abnormal Kidney Function 1 0.5
Diarrhea 1 0.4

HOPE Study:

Safety data in the HOPE trial were collected as reasons for discontinuation or temporary interruption of treatment. The incidence of cough was similar to that seen in the AIRE trial. The rate of angioedema was the same as in previous clinical trials (see WARNINGS).

RAMIPRIL PLACEBO
(N=4645) (N=4652)
% %
Discontinuation at any time 34 32
Permanent discontinuation 29 28
Reasons for stopping Cough 7 2
Hypotension or Dizziness 1.9 1.5
Angioedema 0.3 0.1

Other adverse experiences reported in controlled clinical trials (in less than 1% of ramipril patients), or rarer events seen in postmarketing experience, include the following (in some, a causal relationship to drug use is uncertain):

Body As a Whole: Anaphylactoid reactions. (See WARNINGS.)

Cardiovascular: Symptomatic hypotension (reported in 0.5% of patients in US trials) (See WARNINGS and PRECAUTIONS ), syncope and palpitations.

Hematologic: Pancytopenia, hemolytic anemia and thrombocytopenia.

Renal: Some hypertensive patients with no apparent pre-existing renal disease have developed minor, usually transient, increases in blood urea nitrogen and serum creatinine when taking ALTACE (ramipril capsules) , particularly when ALTACE (ramipril capsules) was given concomitantly with a diuretic. (See WARNINGS.) Acute renal failure.

Angioneurotic Edema: Angioneurotic edema has been reported in 0.3% of patients in US clinical trials. (See WARNINGS.)

Gastrointestinal: Hepatic failure, hepatitis, jaundice, pancreatitis, abdominal pain (sometimes with enzyme changes suggesting pancreatitis), anorexia, constipation, diarrhea, dry mouth, dyspepsia, dysphagia, gastroenteritis, increased salivation and taste disturbance.

Dermatologic: Apparent hypersensitivity reactions (manifested by urticaria, pruritus, or rash, with or without fever), photosensitivity, purpura, onycholysis, pemphigus, pemphigoid, erythema multiforme, toxic epidermal necrolysis, and Stevens-Johnson syndrome.

Neurologic and Psychiatric: Anxiety, amnesia, convulsions, depression, hearing loss, insomnia, nervousness, neuralgia, neuropathy, paresthesia, somnolence, tinnitus, tremor, vertigo, and vision disturbances.

Miscellaneous: As with other ACE inhibitors, a symptom complex has been reported which may include a positive ANA, an elevated erythrocyte sedimentation rate, arthralgia/arthritis, myalgia, fever, vasculitis, eosinophilia, photosensitivity, rash and other dermatologic manifestations. Additionally, as with other ACE inhibitors, eosinophilic pneumonitis has been reported.

Fetal/Neonatal Morbidity and Mortality. See WARNINGS : Fetal/Neonatal Morbidity and Mortality .

Other: arthralgia, arthritis, dyspnea, edema, epistaxis, impotence, increased sweating, malaise, myalgia, and weight gain.

Post-Marketing Experience: In addition to adverse events reported from clinical trials, there have been rare reports of hypoglycemia reported during ALTACE (ramipril capsules) therapy when given to patients concomitantly taking oral hypoglycemic agents or insulin. The causal relationship is unknown.

Clinical Laboratory Test Findings

Creatinine and Blood Urea Nitrogen: Increases in creatinine levels occurred in 1.2% of patients receiving ALTACE (ramipril capsules) alone, and in 1.5% of patients receiving ALTACE (ramipril capsules) and a diuretic. Increases in blood urea nitrogen levels occurred in 0.5% of patients receiving ALTACE (ramipril capsules) alone and in 3% of patients receiving ALTACE (ramipril capsules) with a diuretic. None of these increases required discontinuation of treatment. Increases in these laboratory values are more likely to occur in patients with renal insufficiency or those pretreated with a diuretic and, based on experience with other ACE inhibitors, would be expected to be especially likely in patients with renal artery stenosis. (See WARNINGS and PRECAUTIONS.) Since ramipril decreases aldosterone secretion, elevation of serum potassium can occur. Potassium supplements and potassium-sparing diuretics should be given with caution, and the patient’s serum potassium should be monitored frequently. (See WARNINGS and PRECAUTIONS.)

Hemoglobin and Hematocrit: Decreases in hemoglobin or hematocrit (a low value and a decrease of 5 g/dl or 5% respectively) were rare, occurring in 0.4% of patients receiving ALTACE (ramipril capsules) alone and in 1.5% of patients receiving ALTACE (ramipril capsules) plus a diuretic. No US patients discontinued treatment because of decreases in hemoglobin or hematocrit.

Other (causal relationships unknown): Clinically important changes in standard laboratory tests were rarely associated with ALTACE (ramipril capsules) administration. Elevations of liver enzymes, serum bilirubin, uric acid, and blood glucose have been reported, as have cases of hyponatremia and scattered incidents of leukopenia, eosinophilia, and proteinuria. In US trials, less than 0.2% of patients discontinued treatment for laboratory abnormalities; all of these were cases of proteinuria or abnormal liver-function tests.

Read the entire FDA prescribing information for Altace Capsules (Ramipril Capsules)

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  • Resource Optimization and Innovation LLC
  • Roxane Labs
  • Sandoz
  • Sanofi-Aventis Inc.
  • Southwood Pharmaceuticals
  • Teva Pharmaceutical Industries Ltd.
  • Vangard Labs Inc.
  • Dosage forms

    Form Route Strength
    Capsule Oral 1.25 mg
    Capsule Oral 10 mg
    Capsule Oral 15 mg
    Capsule Oral 5 mg
    Tablet Oral 1.25 mg
    Tablet Oral 1.25 mg/1
    Tablet Oral 10 mg/1
    Tablet Oral 10 mg
    Tablet Oral 2.5 mg/1
    Tablet Oral 2.5 mg
    Tablet Oral 5 mg
    Tablet Oral 5 mg/1
    Capsule Oral
    Tablet Oral
    Capsule Oral 1.25 mg/1
    Capsule Oral 10 mg/1
    Capsule Oral 10 mg/301
    Capsule Oral 2.5 mg/1
    Capsule Oral 2.5 mg
    Capsule Oral 5 mg/1
    Capsule, gelatin coated Oral 1.25 mg/1
    Capsule, gelatin coated Oral 10 mg/1
    Capsule, gelatin coated Oral 2.5 mg/1
    Capsule, gelatin coated Oral 5 mg/1
    Powder 1 kg/1kg
    Tablet Oral

    Prices

    Unit description Cost Unit
    Altace 10 mg capsule 2.87USD capsule
    Altace 2.5 mg capsule 2.54USD capsule
    Altace 5 mg capsule 2.53USD capsule
    Altace 10 mg tablet 2.37USD tablet
    Altace 1.25 mg capsule 2.2USD capsule
    Ramipril 10 mg capsule 2.19USD capsule
    Altace 5 mg tablet 2.02USD tablet
    Altace 2.5 mg tablet 1.93USD tablet
    Ramipril 5 mg capsule 1.87USD capsule
    Ramipril 2.5 mg capsule 1.78USD capsule
    Altace 1.25 mg tablet 1.63USD tablet
    Ramipril 1.25 mg capsule 1.59USD capsule
    Altace 10 mg Tablet 1.14USD tablet
    Altace 2.5 mg Tablet 0.9USD tablet
    Altace 5 mg Tablet 0.9USD tablet
    Altace 1.25 mg Tablet 0.78USD tablet
    Apo-Ramipril 10 mg Tablet 0.64USD tablet
    Co Ramipril 10 mg Tablet 0.64USD tablet
    Jamp-Ramipril 10 mg Tablet 0.64USD tablet
    Mylan-Ramipril 10 mg Tablet 0.64USD tablet
    Novo-Ramipril 10 mg Tablet 0.64USD tablet
    Pms-Ramipril 10 mg Tablet 0.64USD tablet
    Ramipril 10 mg Tablet 0.64USD tablet
    Ran-Ramipril 10 mg Tablet 0.64USD tablet
    Ratio-Ramipril 10 mg Tablet 0.64USD tablet
    Sandoz Ramipril 10 mg Tablet 0.64USD tablet
    Apo-Ramipril 2.5 mg Tablet 0.5USD tablet
    Apo-Ramipril 5 mg Tablet 0.5USD tablet
    Co Ramipril 2.5 mg Tablet 0.5USD tablet
    Co Ramipril 5 mg Tablet 0.5USD tablet
    Jamp-Ramipril 2.5 mg Tablet 0.5USD tablet
    Jamp-Ramipril 5 mg Tablet 0.5USD tablet
    Mylan-Ramipril 2.5 mg Tablet 0.5USD tablet
    Mylan-Ramipril 5 mg Tablet 0.5USD tablet
    Novo-Ramipril 2.5 mg Tablet 0.5USD tablet
    Novo-Ramipril 5 mg Tablet 0.5USD tablet
    Pms-Ramipril 2.5 mg Tablet 0.5USD tablet
    Pms-Ramipril 5 mg Tablet 0.5USD tablet
    Ramipril 2.5 mg Tablet 0.5USD tablet
    Ramipril 5 mg Tablet 0.5USD tablet
    Ran-Ramipril 2.5 mg Tablet 0.5USD tablet
    Ran-Ramipril 5 mg Tablet 0.5USD tablet
    Ratio-Ramipril 2.5 mg Tablet 0.5USD tablet
    Ratio-Ramipril 5 mg Tablet 0.5USD tablet
    Sandoz Ramipril 2.5 mg Tablet 0.5USD tablet
    Sandoz Ramipril 5 mg Tablet 0.5USD tablet
    Apo-Ramipril 1.25 mg Tablet 0.44USD tablet
    Co Ramipril 1.25 mg Tablet 0.44USD tablet
    Jamp-Ramipril 1.25 mg Tablet 0.44USD tablet
    Mylan-Ramipril 1.25 mg Tablet 0.44USD tablet
    Pms-Ramipril 1.25 mg Tablet 0.44USD tablet
    Ramipril 1.25 mg Tablet 0.44USD tablet
    Ran-Ramipril 1.25 mg Tablet 0.44USD tablet
    Ratio-Ramipril 1.25 mg Tablet 0.44USD tablet
    Sandoz Ramipril 1.25 mg Tablet 0.44USD tablet

    DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only. Patents

    Patent Number Pediatric Extension Approved Expires (estimated)
    Unlock Additional Data
    US5403856 No 1995-04-04 2012-04-04 US
    CA2382387 No 2005-06-21 2020-08-25 Canada
    CA1338344 No 1996-05-21 2013-05-21 Canada
    US7368469 No 2008-05-06 2020-08-30 US

    Additional Data Available

    • Filed On Filed On

      The date on which a patent was filed with the relevant government.

      Learn more

    Properties

    State Solid Experimental Properties

    Property Value Source
    melting point (°C) 109 °C PhysProp
    water solubility 3.5mg/L Not Available
    logP 2.9 Not Available

    Predicted Properties

    Property Value Source
    Water Solubility 0.039 mg/mL ALOGPS
    logP 0.92 ALOGPS
    logP 1.47 ChemAxon
    logS -4 ALOGPS
    pKa (Strongest Acidic) 3.75 ChemAxon
    pKa (Strongest Basic) 5.2 ChemAxon
    Physiological Charge -1 ChemAxon
    Hydrogen Acceptor Count 5 ChemAxon
    Hydrogen Donor Count 2 ChemAxon
    Polar Surface Area 95.94 Å2 ChemAxon
    Rotatable Bond Count 10 ChemAxon
    Refractivity 111.19 m3·mol-1 ChemAxon
    Polarizability 44.79 Å3 ChemAxon
    Number of Rings 3 ChemAxon
    Bioavailability 1 ChemAxon
    Rule of Five Yes ChemAxon
    Ghose Filter Yes ChemAxon
    Veber’s Rule No ChemAxon
    MDDR-like Rule Yes ChemAxon

    Predicted ADMET features

    Property Value Probability
    Human Intestinal Absorption + 0.9159
    Blood Brain Barrier 0.8726
    Caco-2 permeable 0.8491
    P-glycoprotein substrate Substrate 0.7263
    P-glycoprotein inhibitor I Non-inhibitor 0.7002
    P-glycoprotein inhibitor II Inhibitor 0.6295
    Renal organic cation transporter Non-inhibitor 0.8869
    CYP450 2C9 substrate Non-substrate 0.8541
    CYP450 2D6 substrate Non-substrate 0.8969
    CYP450 3A4 substrate Non-substrate 0.5082
    CYP450 1A2 substrate Non-inhibitor 0.9045
    CYP450 2C9 inhibitor Non-inhibitor 0.907
    CYP450 2D6 inhibitor Non-inhibitor 0.9304
    CYP450 2C19 inhibitor Non-inhibitor 0.9025
    CYP450 3A4 inhibitor Non-inhibitor 0.8309
    CYP450 inhibitory promiscuity Low CYP Inhibitory Promiscuity 0.5691
    Ames test Non AMES toxic 0.9108
    Carcinogenicity Non-carcinogens 0.9267
    Biodegradation Not ready biodegradable 0.8903
    Rat acute toxicity 1.6732 LD50, mol/kg Not applicable
    hERG inhibition (predictor I) Weak inhibitor 0.98
    hERG inhibition (predictor II) Non-inhibitor 0.7901

    ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

    Spectra

    Mass Spec (NIST) Not Available Spectra

    Taxonomy

    Description This compound belongs to the class of organic compounds known as dipeptides. These are organic compounds containing a sequence of exactly two alpha-amino acids joined by a peptide bond. Kingdom Organic compounds Super Class Organic acids and derivatives Class Carboxylic acids and derivatives Sub Class Amino acids, peptides, and analogues Direct Parent Dipeptides Alternative Parents Alpha amino acid esters / N-acyl-L-alpha-amino acids / Alpha amino acid amides / Pyrrolidine carboxylic acids / N-acylpyrrolidines / Fatty acid esters / Aralkylamines / Dicarboxylic acids and derivatives / Benzene and substituted derivatives / Tertiary carboxylic acid amidesAmino acids / Carboxylic acid esters / Dialkylamines / Azacyclic compounds / Carboxylic acids / Organopnictogen compounds / Organic oxides / Hydrocarbon derivatives / Carbonyl compounds show 9 more Substituents Alpha-dipeptide / Alpha-amino acid ester / N-acyl-l-alpha-amino acid / N-acyl-alpha-amino acid / N-acyl-alpha amino acid or derivatives / Alpha-amino acid amide / Alpha-amino acid or derivatives / Pyrrolidine carboxylic acid / Pyrrolidine carboxylic acid or derivatives / N-acylpyrrolidineFatty acid ester / Aralkylamine / Monocyclic benzene moiety / Dicarboxylic acid or derivatives / Benzenoid / Fatty acyl / Tertiary carboxylic acid amide / Pyrrolidine / Amino acid or derivatives / Carboxamide group / Carboxylic acid ester / Amino acid / Azacycle / Secondary aliphatic amine / Carboxylic acid / Organoheterocyclic compound / Secondary amine / Hydrocarbon derivative / Amine / Organopnictogen compound / Organic oxygen compound / Carbonyl group / Organic oxide / Organic nitrogen compound / Organonitrogen compound / Organooxygen compound / Aromatic heteropolycyclic compound show 27 more Molecular Framework Aromatic heteropolycyclic compounds External Descriptors dicarboxylic acid monoester, ethyl ester, azabicycloalkane, dipeptide, cyclopentapyrrole (CHEBI:8774)

    Targets

    Binding Properties

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    Property Measurement pH Temperature (°C)
    IC 50 (nM) 4 N/A N/A 10669559

    Details Binding Properties1. Angiotensin-converting enzyme Kind Protein Organism Humans Pharmacological action Yes Actions Inhibitor General Function Zinc ion binding Specific Function Converts angiotensin I to angiotensin II by release of the terminal His-Leu, this results in an increase of the vasoconstrictor activity of angiotensin. Also able to inactivate bradykinin, a potent… Gene Name ACE Uniprot ID P12821 Uniprot Name Angiotensin-converting enzyme Molecular Weight 149713.675 Da Kind Protein Organism Humans Pharmacological action Unknown General Function Peptide binding Specific Function This is a receptor for bradykinin. Could be a factor in chronic pain and inflammation. Gene Name BDKRB1 Uniprot ID P46663 Uniprot Name B1 bradykinin receptor Molecular Weight 40494.29 Da

    1. Ignjatovic T, Tan F, Brovkovych V, Skidgel RA, Erdos EG: Novel mode of action of angiotensin I converting enzyme inhibitors: direct activation of bradykinin B1 receptor. J Biol Chem. 2002 May 10;277(19):16847-52. Epub 2002 Mar 5.

    Enzymes

    Details1. Cholinesterase Kind Protein Organism Humans Pharmacological action Unknown Actions Inhibitor General Function Identical protein binding Specific Function Esterase with broad substrate specificity. Contributes to the inactivation of the neurotransmitter acetylcholine. Can degrade neurotoxic organophosphate esters. Gene Name BCHE Uniprot ID P06276 Uniprot Name Cholinesterase Molecular Weight 68417.575 Da

    1. Shah GB, Sharma S, Mehta AA, Goyal RK: Oculohypotensive effect of angiotensin-converting enzyme inhibitors in acute and chronic models of glaucoma. J Cardiovasc Pharmacol. 2000 Aug;36(2):169-75.

    Transporters

    Kind Protein Organism Humans Pharmacological action Unknown Actions Substrate General Function Proton-dependent oligopeptide secondary active transmembrane transporter activity Specific Function Proton-coupled intake of oligopeptides of 2 to 4 amino acids with a preference for dipeptides. May constitute a major route for the absorption of protein digestion end-products. Gene Name SLC15A1 Uniprot ID P46059 Uniprot Name Solute carrier family 15 member 1 Molecular Weight 78805.265 Da Kind Protein Organism Humans Pharmacological action Unknown Actions Substrate General Function Peptide:proton symporter activity Specific Function Proton-coupled intake of oligopeptides of 2 to 4 amino acids with a preference for dipeptides. Gene Name SLC15A2 Uniprot ID Q16348 Uniprot Name Solute carrier family 15 member 2 Molecular Weight 81782.77 Da ×Unlock Data

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    Drug created on June 13, 2005 07:24 / Updated on February 02, 2020 00:10

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