Monograph Details
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Cardiovascular System
> Hypertension
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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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Hypertension. To reduce risk of MI, stroke, or death from cardiovascular causes in high-risk patients ≥55 years old (see literature). |
| 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. Hypertension: initially 2.5mg once daily; maintenance: 2.5–20mg daily in single or 2 divided doses. If on diuretic: suspend diuretic, if possible, 2–3 days before starting; resume diuretic if pressure not controlled with ramipril alone. If diuretic cannot be discontinued: initially 1.25mg once daily. Cardiovascular risk reduction: initially 2.5mg once daily for 1 week, then 5mg once daily for 3 weeks; maintenance 10mg once daily or in 2 divided doses. For both: (CrCl <40mL/min): 1.25mg once daily; max 5mg/day. |
| 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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Headache, dizziness, fatigue, cough, hypotension, 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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