Altace

The recommended adult dose of Altace (Ramipril) ranges from 2.5 mg to 10 mg daily in 1 or 2 divided doses, depending on the dose and circumstances. The maximum daily dose of Altace (Ramipril) is 20 mg.

To treat high blood pressure, the usual starting dose for people not using diuretics (water pills) is 2.5 mg once daily. The dose is usually increased according to need every 2 weeks. The usual dose range is between 2.5 mg and 10 mg daily. For people using diuretics, your doctor may start with a lower dose of 1.25 mg daily or ask you to stop using the diuretic for 2 or 3 days before starting Altace (Ramipril).

For people at increased risk of heart disease events, the recommended starting dose is 2.5 mg once daily, increasing gradually to 10 mg daily if tolerated.

For treatment following a heart attack, the usual starting dose varies depending on existing medical conditions, blood pressure, and other medications. The recommended starting dose is 2.5 mg twice daily, increased every 1 to 3 days if appropriate. The dose should not exceed 5 mg twice daily. A lower dose of 1.25 mg twice daily may be needed for those who experience Low Blood Pressure as a result of taking the medication.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that Altace (Ramipril) be taken exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Altace (Ramipril) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause unusual tiredness; it may alter your sense of taste; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun; on occasion, it may cause a dry cough - contact your pharmacist or doctor if it becomes bothersome. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

1.25 mg
Each size "4" hard gelatin capsule with white opaque body imprinted with "Altace" and yellow opaque cap imprinted with "1.25" contains 1.25 mg of Altace (Ramipril). Nonmedicinal ingredients: pregelatinized starch; capsule: gelatin, titanium dioxide, and yellow iron oxide.

2.5 mg
Each size "4" hard gelatin capsule with white opaque body imprinted with "Altace" and orange opaque cap imprinted with "2.5" contains 2.5 mg of Altace (Ramipril). Nonmedicinal ingredients:pregelatinized starch; capsule: FD&C Red No. 3, gelatin, titanium dioxide, and yellow iron oxide.

5 mg
Each size "4" hard gelatin capsule with white opaque body imprinted with "Altace" and red opaque cap imprinted with "5" contains 5 mg of Altace (Ramipril). Nonmedicinal ingredients: pregelatinized starch; capsule: FD&C Blue No. 2, FD&C Red No. 3, gelatin, and titanium dioxide.

10 mg
Each size "4" hard gelatin capsule with white opaque body imprinted with "Altace" and blue opaque cap imprinted with "10" contains 10 mg of Altace (Ramipril). Nonmedicinal ingredients: pregelatinized starch; capsule: black iron oxide, FD&C Blue No. 2, FD&C Red No. 3, gelatin, and titanium dioxide.

15 mg
Each size "3" hard gelatin capsule with grey opaque body imprinted with "Altace" and powder blue opaque cap imprinted with "15" contains 15 mg of Altace (Ramipril). Nonmedicinal ingredients: pregelatinized starch; capsule: black iron oxide, D&C Red No. 28, FD&C Blue No. 1, gelatin, and titanium dioxide.

Do not take Altace (Ramipril) if you:

• are allergic to Altace (Ramipril), or any other ACE inhibitor, or any ingredients of the medication
• are breast-feeding
• are pregnant
• have had angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell)
• have been diagnosed with hereditary angioedema
• have low blood pressure
• have narrowing of the blood vessels to the kidneys
• are taking the medication sacubitril-valsartan
• are taking the medication Aliskiren or angiotensin II receptor antagonists and have
  • Diabetes
  • moderate to severely decreased kidney function
  • high levels of potassium in the blood
  • Congestive Heart Failure with low blood pressure
• are receiving dialysis or other similar treatments

There may be an interaction between Altace (Ramipril) and any of the following:

• acetylsalicylic acid (Asa)
• Aldesleukin
• aliskiren
• allergy shots for bee or wasp stings
• Allopurinol
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• amifostine
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• other angiotensin converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Altace (Ramipril))
• angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• atypical antipsychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• Azathioprine
• barbiturates (e.g., Phenobarbital, butalbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• brimonidine
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• ciprofloxacin
• conivaptan
• Cyclosporine
• diuretics (water pills; e.g., Furosemide, Amiloride, Spironolactone, triamterene)
• drospirenone
• Duloxetine
• Everolimus
• "gliptin" diabetes medications (e.g., Linagliptin, Saxagliptin, Sitagliptin)
• gold injections (sodium aurothiomalate)
• grass pollen extract
• Guanfacine
• Heparin
• insulin
• iron dextran
• iron supplements
• levodopa
• lithium
• low-molecular-weight heparins (e.g., Dalteparin, Tinzaparin)
• Methylphenidate
• Minoxidil
• mycophenolate
• narcotic medications (e.g., Codeine, Morphine)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., Indomethacin, Naproxen)
• Obinutuzumab
• oral diabetes medications (e.g., Canagliflozin, Glyburide, Gliclazide, Metformin, Pioglitazone, saxagliptin)
• Pentoxifylline
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pregabalin
• procainamide
• quinine
• sacubitril
• Selegiline
• Sirolimus
• sodium phosphates
• substances that increase potassium levels (e.g., potassium chloride, salt substitutes containing potassium)
• Temsirolimus
• Tizanidine
• Tolvaptan
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Trimethoprim
• Yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Altace (Ramipril). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Altace (Ramipril).

Angioedema: Altace (Ramipril) may cause a serious allergic reaction called angioedema, which may be fatal if not treated promptly. If you have difficulty breathing or notice hives or swelling of the face, lips, tongue, or throat, or experience severe abdominal pain, stop taking Altace (Ramipril) and get emergency medical help at once. Other ACE inhibitors should not be taken in the future. People who have had angioedema caused by other substances may be at increased risk of angioedema while taking Altace (Ramipril).

Blood disorders: In rare cases, a low white blood cell count has been reported with people taking Altace (Ramipril). Your doctor may occasionally monitor your level of white blood cells by performing blood tests. Low white blood cell levels may increase your risk for infection. If you notice any signs of infection (e.g. fever, sore throat), contact your doctor as soon as possible.

Cough: People taking Altace (Ramipril) may develop a dry, persistent cough that usually disappears only after stopping or lowering the dose of Altace (Ramipril).

Kidney function: Decreased kidney function or Kidney Disease can cause Altace (Ramipril) to build up in the body, causing side effects. Also, Altace (Ramipril) can cause decreases in kidney function. Certain people, such as those with narrowed blood vessels in their kidneys or severe congestive heart failure, may be more likely to experience this complication. The use of other diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase risk of kidney problems.

If you have reduced kidney function or kidney disease, discuss with your doctor how Altace (Ramipril) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Altace (Ramipril), and whether any special monitoring is needed. People with kidney function impairment may require lower doses of Altace (Ramipril).

Liver function: Altace (Ramipril) may cause liver problems. If you experience any signs of liver problems such as yellowing of the skin or eyes, fever, generally feeling unwell, abdominal pain, nausea, vomiting, loss of appetite, itching, muscle pain, rash, or swollen glands, contact your doctor immediately. If you have liver problems, you will need to be closely monitored by your doctor while taking Altace (Ramipril).

Low blood pressure: Occasionally, blood pressure drops too low after taking Altace (Ramipril). This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take diuretics, or the medication aliskiren, have a salt-restricted diet, are on dialysis, have diarrhea, or are vomiting. To reduce the risk of dizziness, get up slowly from a lying or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact a doctor.

Potassium: Increases in blood levels of potassium can occur with use of Altace (Ramipril). This rarely causes problems, but your doctor may want to monitor your potassium levels through blood tests.

Reduced alertness: Altace (Ramipril) may reduce alertness, especially at the beginning of treatment. Do not drive or perform tasks that require alertness until you know how Altace (Ramipril) affects you.

Surgery: It is important that your physician and anesthesiologist know that you are taking Altace (Ramipril) before you undergo any surgical procedures requiring general anesthesia.

Pregnancy: ACE inhibitors such as Altace (Ramipril) may cause severe harm or death to the developing baby if taken by the mother during pregnancy. Altace (Ramipril) should not be used during pregnancy. If you become pregnant while taking Altace (Ramipril), stop taking it immediately and contact your doctor.

Breast-feeding: Altace (Ramipril) passes into breast milk. If you are a breast-feeding mother and are taking Altace (Ramipril) it may affect your baby. Altace (Ramipril) is not recommended for breast-feeding women. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Altace (Ramipril) have not been established for children. The use of Altace (Ramipril) by this age group is not recommended.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. You should take this medication at approximately the same time each day. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food.