Monograph Details
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Cardiovascular System
> CHF and arrhythmias
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ALTACE |
| Manufacturer |
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King Pharmaceuticals, Inc. |
| Legal Classification |
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Rx
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| Pharmacological Class |
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ACE inhibitor. |
| Generic Name |
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Ramipril 1.25mg, 2.5mg, 5mg, 10mg; caps, tabs. |
| Indications |
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Treatment of CHF in stabilized patients after MI, to reduce mortality, hospitalizations, and progression to severe/resistant heart failure. |
| Children |
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Not recommended. |
| Adults |
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May sprinkle contents of caps on 4oz applesauce or mix in 4oz water or apple juice. Adjust at 3-week intervals. Initially 2.5mg twice daily, if hypotension occurs may reduce to 1.25mg twice daily; usual maintenance: 5mg twice daily. CrCl <40mL/min per 1.73m2: initially 1.25mg once daily; max 2.5mg twice daily. |
| Contraindications |
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History of ACEI-associated or other angioedema. Pregnancy (Cat.D in 2nd and 3rd trimesters). |
| Precautions |
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Salt/volume depletion. Renal or hepatic impairment (discontinue if jaundice or marked increases in hepatic enzymes occur). Severe CHF. Dialysis (esp. high-flux membrane). Monitor WBCs in collagen vascular disease. Monitor renal function in severe CHF, hypertension, or renal artery stenosis. Monitor for hyperkalemia in diabetes or renal insufficiency. Surgery. Discontinue if angioedema or laryngeal stridor occurs. Pregnancy (Cat.C in 1st trimester). Nursing mothers: not recommended. |
| Interactions |
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K+ supplements, K+ sparing diuretics, K+ containing salt substitutes may cause hyperkalemia. May increase lithium levels. Excessive hypotension with diuretics (reduce diuretic dose if possible). |
| Adverse Reactions |
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Hypotension, cough, dizziness, angina, GI upset, postural hypotension, syncope, vertigo, headache, hyperkalemia. |
| How Supplied |
Caps 1.25mg—100
2.5mg, 5mg, 10mg—100, 500, 1000
Tabs—100 |
| Additional Resources |
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• Related Prescribing Note |
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