section name header

Pronunciation ⬇

ra-MI-pril

Classifications ⬆ ⬇

Therapeutic Classification: antihypertensives

Pharmacologic Classification: ace inhibitors

Indications ⬆ ⬇

REMS

Action ⬆ ⬇

  • Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also prevent the degradation of bradykinin and other vasodilatory prostaglandins. ACE inhibitors also ↑ plasma renin levels and ↓ aldosterone levels. Net result is systemic vasodilation.
Therapeutic effects:
  • Lowering of BP in hypertensive patients.
  • Decreased risk of myocardial infarction, stroke, or death from cardiovascular causes in high-risk patients.
  • Increased survival and decreased heart failure progression after myocardial infarction.

Pharmacokinetics ⬆ ⬇

Absorption: 50–60% absorbed following oral administration.

Distribution: Crosses the placenta; may enter breast milk.

Metabolism/Excretion: Converted by the liver to ramiprilat, the active metabolite; 60% excreted in urine; 40% in feces.

Half-Life: Ramiprilat:13–17 hr (↑ in renal impairment).

Time/Action Profile ⬆ ⬇

(effect on BP—single dose‡)
ROUTEONSETPEAKDURATION
POwithin 1–2 hr3–6 hr24 hr



‡Full effects may not be noted for several wk.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension, chest pain

Derm: rashes

F and E: hyperkalemia

GI: diarrhea, nausea, vomiting

GU: impaired renal function

Neuro: dizziness, fatigue, headache, vertigo, weakness

Resp: cough

Misc: ANGIOEDEMA

Interactions ⬆ ⬇

Drug-drug:

Route/Dosage ⬆ ⬇

Hypertension

Heart Failure Post-Myocardial Infarction

Reduction in Risk of MI, Stroke, and Death from Cardiovascular Causes

Renal Impairment

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Implementation ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Altace

Code ⬆

NDC Code