Side Effects of Ramipril

Ramipril (brand name Altace) is a medication used to treat hypertension (high blood pressure) 1. says that ramipril is an angiotensin-converting enzyme (ACE) inhibitor that works to relax blood vessels, lowering blood pressure as a result 1. According to the National Library of Medicine, you will start taking 1.25mg of ramipril daily 13. Your doctor will increase the dosage based on your risk factors for a myocardial infarction (heart attack) or stroke.

Common Side Effects

According to, ramipril can cause such common side effects as trouble sleeping, a cough and vomiting 1. Chronic vomiting can cause you to become very dehydrated and hypokalemic (low potassium levels). Drink eight to 10 glasses of water daily, and eat a diet rich in fruits and vegetables. Ramipril can also cause nausea, itching, a headache and a cough 1. It can change your libido (sex drive) and result in impotence. Tell your physician when these effects remain for longer than two days.

Potentially Fatal Side Effects

According to the National Library of Medicine, ramipril can cause many potentially fatal side effects 13. It can cause head, neck and intestinal angioedemas. Head and neck angioedemas refer to swelling of the face, lips, throat and tongue. When your tongue and throat are swollen, your airway becomes blocked, you become cyanotic (turn blue) and can pass out, with death as a possible result. Intestinal angioedema refers to severe swelling of your intestines. Symptoms of this condition include stomach pain, nausea or vomiting.

Ramipril can also cause hypotension (low blood pressure) and hepatic (liver) failure 1. Hypotension decreases the amount of blood that flows to your vital organs. If left untreated, your body can go into shock. Signs of liver failure include jaundice (yellowing of your eyes or skin) and elevated liver enzymes.

Other Serious Side Effects

According to, ramipril can also cause infrequent urination, easy bruising or bleeding, chest pain and bradycardia (slow heartbeat) 1. Infrequent urination can increase your blood urea nitrogen (BUN) level in your blood. This is typically an indication of dehydration. Drink plenty of fluids, as prolonged decrease in urination can lead to acute kidney failure. Easy bleeding and bruising results from thrombocytopenia, a condition of lowered platelet counts. Platelets aid your blood in the clotting process. Ramipril can also cause rapid weight gain and muscle weakness 1. Tell your doctor when you have these symptoms. The National Library of Medicine says that ramipril can also cause hyperkalemia (high potassium levels) and neutropenia (low white blood cells) 13. Hyperkalemia can adversely affect your heart rhythm, while neutropenia makes you prone to infections.

Additional Concerns

Do not take ramipril if you are hypersensitive to this medication 1. The following allergic symptoms can ensue: trouble breathing, angioedema (swelling of your tongue or face) and hives. Call 911.

Avoid ramipril especially during the second and third trimesters of pregnancy 1. According to the National Library of Medicine, ramipril can cause harm--and even death--to your baby 13.

Tell your doctor if you breastfeed. Low concentrations of ramipril can contaminate your breast milk and subsequently harm your baby 1.

Do not take ramipril with such drugs as aspirin, lithium, gold injections or diuretics, says 1. Ramipril combined with these medications may lead to the aforementioned effects 1.