Altace is an ACE inhibitor. ACE stands for angiotensin converting enzyme.

Altace is used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.

Altace is also used to treat congestive heart failure.

Do not Altace use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away.

You should not use Altace if you have ever had angioedema. Do not take ramipril within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use ramipril together with any medication that contains aliskiren (a blood pressure medicine).

Take Altace exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Swallow the tablet whole.

Your blood pressure will need to be checked often, and you may need blood tests.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking Altace. This can lead to very low blood pressure, electrolyte disorders, or kidney failure.

If you need surgery, tell the surgeon ahead of time that you are using ramipril.

If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

Usual Adult Dose for Diabetic Nephropathy:

Initial dose: 2.5 mg orally once a day for patients not receiving a diuretic
Maintenance dose: 2.5 to 20 mg/day orally in 1 to 2 divided doses

Usual Adult Dose for Hypertension:

Initial dose: 2.5 mg orally once a day for patients not receiving a diuretic
Maintenance dose: 2.5 to 20 mg/day orally in 1 to 2 divided doses

Usual Adult Dose for Congestive Heart Failure:

Initial dose: 2.5 mg orally twice a day
Maintenance dose: 5 mg orally twice a day

Usual Adult Dose for Left Ventricular Dysfunction:

Initial dose: 2.5 mg orally twice a day
Maintenance dose: 5 mg orally twice a day

Usual Adult Dose for Myocardial Infarction:

Initial dose: 2.5 mg orally twice a day
Maintenance dose: 5 mg orally twice a day

You should not use Altace if you are allergic to ramipril, or if:

• you recently took a heart medicine called sacubitril; or

• you have ever had a severe allergic reaction to any ACE inhibitor (benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, or trandolapril).

Do not take Altace within 36 hours before or after taking medicine that contains sacubitril (such as Entresto).

If you have diabetes, do not use ramipril together with any medication that contains aliskiren (a blood pressure medicine).

You may also need to avoid taking ramipril with aliskiren if you have kidney disease.

To make sure Altace is safe for you, tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);

• an electrolyte imbalance (such as high levels of potassium in your blood);

• liver disease;

• a connective tissue disease such as Marfan syndrome, Sjogren's syndrome, lupus, scleroderma, or rheumatoid arthritis;

• if you are on a low-salt diet; or

• if you are also taking telmisartan (Micardis).

Do not use if you are pregnant. If you become pregnant, stop taking this medicine and tell your doctor right away. Altace can cause injury or death to the unborn baby if you take the medicine during your second or third trimester.

You should not breast-feed while you are using ramipril.

Altace is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Do not use potassium supplements or salt substitutes, unless your doctor has told you to.

Get emergency medical help if you have signs of an allergic reaction to Altace: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat. You may be more likely to have an allergic reaction if you are African-American.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• jaundice (yellowing of your skin or eyes);

• little or no urination;

• fever, chills, sore throat; or

• high potassium - nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common Altace side effects may include:

• headache;

• cough; or

• dizziness, weakness, tired feeling.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your current medicines. Many drugs can interact with Altace, especially:

• a diuretic ("water pill"), or any other blood pressure medications;

• lithium;

• gold injections to treat arthritis;

• insulin or oral diabetes medicine; or

• NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete and many other drugs may interact with Altace. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.