Summary
Commonly reported side effects of ramipril include: hypotension and increased cough. Continue reading for a comprehensive list of adverse effects.
Applies to ramipril: oral capsules.
Warning
- May cause fetal and neonatal morbidity and mortality if used during pregnancy.1 39 40 41 42 43 44 45 46 88 89 (See Fetal/Neonatal Morbidity and Mortality under Cautions.)
- If pregnancy is detected, discontinue ramipril as soon as possible.1 89
Side effects include:
Patients with hypertension: Headache, dizziness, fatigue.
Patients with heart failure: Dizziness, cough, nausea, vomiting, angina pectoris, syncope, postural hypotension, vertigo, hypotension.
For Healthcare Professionals
Applies to ramipril: oral capsule, oral tablet.
General
The most common adverse reaction is hypotension.[Ref]
Cardiovascular
Very common (10% or more): Hypotension (11%)
Common (1% to 10%): Angina pectoris, postural hypotension, orthostatic blood pressure decreased
Uncommon (0.1% to 1%): Symptomatic hypotension, myocardial ischemia, myocardial infarction, tachycardia, arrhythmia, palpitation, flushing
Rare (less than 0.1%): Vascular stenosis, hypoperfusion, vasculitis
Frequency not reported: Disturbed orthostatic regulation, Raynaud's phenomenon[Ref]
Gastrointestinal
Common (1% to 10%): Nausea, vomiting, diarrhea, gastrointestinal inflammation, digestive disturbances, abdominal discomfort, dyspepsia
Uncommon (0.1% to 1%): Pancreatitis, pancreatic enzymes increased, abdominal pain, small bowel angioedema, gastritis, constipation, dry mouth
Rare (less than 0.1%): Glossitis
Frequency not reported: Dysphagia, gastroenteritis, increased salivation, gastric pain, aphthous stomatitis[Ref]
Other
Common (1% to 10%): Fatigue, asthenia, vertigo, bronchitis, sinusitis, chest pain
Uncommon (0.1% to 1%): Peripheral edema, pyrexia, libido decreased
Rare (less than 0.1%): Conjunctivitis, hearing impaired, tinnitus
Frequency not reported: Hearing loss, edema, malaise, gynecomastia[Ref]
Respiratory
Common (1% to 10%): Cough, nonproductive tickling cough, cough increased, dyspnea
Uncommon (0.1% to 1%): Bronchospasm, asthma aggravated
Frequency not reported: Eosinophilic pneumonitis, epistaxis, nasal congestion[Ref]
Psychiatric
Uncommon (0.1% to 1%): Depressed mood, anxiety, nervousness, restlessness, sleep disorder
Rare (less than 0.1%): Confusional state
Frequency not reported: Depression, insomnia, disturbance in attention[Ref]
Nervous system
Common (1% to 10%): Headache, dizziness, syncope
Uncommon (0.1% to 1%): Paresthesia, dysgeusia, ageusia, somnolence
Rare (less than 0.1%): Tremor, balance disorder
Frequency not reported: Smell disturbance, amnesia, convulsions, neuralgia, neuropathy, cerebral ischemia, ischemic stroke, transient ischemic attack, psychomotor skills impaired, burning sensation, parosmia[Ref]
Musculoskeletal
Common (1% to 10%): Muscle spasm, myalgia
Uncommon (0.1% to 1%): Arthralgia
Frequency not reported: Arthritis[Ref]
Dermatologic
Common (1% to 10%): Maculopapular rash
Uncommon (0.1% to 1%): Pruritus, hyperhidrosis
Rare (less than 0.1%): Exfoliative dermatitis, urticaria, onycholysis
Frequency not reported: Purpura, pemphigus, pemphigoid, erythema multiforme, toxic epidermal necrolysis, Stevens Johnson syndrome, sweating increased, alopecia, psoriasis aggravated, dermatitis psoriasiform, lichenoid exanthema, enanthema[Ref]
Renal
Common (1% to 10%): Abnormal kidney function
Uncommon (0.1% to 1%): Renal impairment, acute renal failure[Ref]
Metabolic
Common (1% to 10%): Creatinine increased, blood potassium increased
Uncommon (0.1% to 1%): Anorexia, decreased appetite, BUN increased
Frequency not reported: Weight gain, hyponatremia, loss of appetite, uric acid elevated, blood glucose elevated, blood sodium decreased
Postmarketing reports: Hypoglycemia[Ref]
Genitourinary
Uncommon (0.1% to 1%): Worsening of preexisting proteinuria, urine output increased, transient erectile impotence
Frequency not reported: Proteinuria, impotence[Ref]
Ocular
Uncommon (0.1% to 1%): Visual disturbance, blurred vision[Ref]
Hematologic
Uncommon (0.1% to 1%): Eosinophilia, hemoglobin or hematocrit decreased
Rare (less than 0.1%): Neutropenia, agranulocytosis, white blood cell count decreased, red blood cell count decreased, platelet count decreased
Frequency not reported: Pancytopenia, hemolytic anemia, thrombocytopenia, leucopenia, bone marrow failure[Ref]
Hepatic
Uncommon (0.1% to 1%): Hepatic enzymes increased, conjugated bilirubin increased
Rare (less than 0.1%): Cholestatic jaundice, hepatocellular damage
Frequency not reported: Hepatic failure, hepatitis, jaundice, acute liver failure, hepatocellular damage, cholestatic hepatitis, cytolytic hepatitis, serum bilirubin elevated[Ref]
Immunologic
Uncommon (0.1% to 1%): Angioneurotic edema, angioedema
Very rare (less than 0.01%): Photosensitivity
Frequency not reported: Anaphylactic reaction, anaphylactoid reaction, apparent hypersensitivity reaction, antinuclear antibody increased[Ref]
Endocrine
Frequency not reported: Syndrome of inappropriate antidiuretic hormone secretion[Ref]
