Ramipril

An ACE inhibitor widely used for hypertension, heart failure, and heart protection.

What is Ramipril?

Ramipril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure, heart failure, and to reduce the risk of heart attack and stroke.

It works by relaxing blood vessels and lowering blood pressure.

History & Background

Ramipril gained prominence after large clinical trials showed its ability to significantly reduce cardiovascular events and mortality.

Chemical Structure & Properties

• IUPAC name: (2S,3aS,6aS)-1-[(S)-N-[(S)-1-ethoxycarbonyl-3-phenylpropyl]alanyl]octahydrocyclopenta[b]pyrrole-2-carboxylic acid
• Molecular formula: C₂₃H₃₂N₂O₅
• Molar mass: 416.51 g/mol
• Functional groups: Ester, amide, carboxylic acid

Mechanism of Action

Ramipril lowers blood pressure by:

• Inhibiting ACE enzyme
• Reducing angiotensin II formation
• Decreasing aldosterone secretion
• Promoting vasodilation

Pharmacokinetics

• Prodrug: Converted to ramiprilat
• Absorption: Good oral absorption
• Peak plasma time: 1–3 hours
• Half-life: 13–17 hours (ramiprilat)
• Excretion: Urine and bile

Medical Uses

• Hypertension
• Heart failure
• Post-myocardial infarction
• Prevention of cardiovascular events

Dosage Guidelines

Adults: 2.5–10 mg once daily

Initial dose: 2.5 mg daily

⚠️ Monitor blood pressure, kidney function, and potassium levels.

Side Effects

• Dry cough
• Dizziness
• Hyperkalemia
• Hypotension

Warnings & Precautions

• Contraindicated in pregnancy
• Risk of angioedema
• Use caution in renal artery stenosis

Drug Interactions

• Potassium supplements
• Potassium-sparing diuretics
• NSAIDs

Frequently Asked Questions

Does ramipril cause cough? – Yes, in some patients.

Is it heart-protective? – Yes.

Is it safe long-term? – Yes, with monitoring.

Can diabetics use it? – Yes.

⚠️ Educational content only. Not a substitute for professional medical advice.