DRUG INTERACTIONS: The use of ACE inhibitors with potassium supplements, salt substitutes or diuretics (for example, spironolactone (Aldactone) )that increase potassium in the blood may lead to excessive potassium levels. Potassium levels should be monitored whenever ACE inhibitors are used in combination with these drugs.
There have been reports of increased lithium (Eskalith, Lithobid) levels when lithium is used in combination with ACE inhibitors. The reason for this interaction is not known.
There have been reports that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever etc), indomethacin (Indocin, Indocin-SR), and naproxen (Anaprox, Naprelan, Naprosyn, Aleve) may reduce the effects of ACE inhibitors.
PREGNANCY: ACE inhibitors, including ramipril, are harmful to the fetus and, therefore, should not be used during pregnancy.
NURSING MOTHERS: Ramipril should not be administered to women who are breast-feeding.
SIDE EFFECTS: Ramipril generally is well tolerated, and side effects are usually mild and transient. A dry, persistent cough has been reported with the use of ramipril and other ACE inhibitors. Coughing resolves after discontinuing the drug. Other side effects include abdominal pain, constipation, diarrhea, rash, dizziness, fatigue, headache, loss of taste, loss of appetite, nausea, vomiting, fainting and numbness or tingling in the hands or feet.
Ramipril and other ACE inhibitors also may cause kidney failure and increased levels of potassium in the blood. The most serious but, fortunately, very rare side effects are liver failure and angioedema (swelling of lips and throat that can obstruct breathing).
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