How can this medicine affect other medicines?

When taken together with other medicines that decrease blood pressure there is an increased risk of a large drop in blood pressure, particularly with the first dose. People taking high doses of diuretics such as frusemide should, if possible, have their diuretic dose reduced or stopped before introducing ramipril, in order to reduce the risk of a profound drop in blood pressure. This medicine reduces the ability of the body to remove lithium, which may give rise to increased lithium levels in the blood and adverse effects. If taken together with potassium sparing diuretics, potassium supplements or potassium containing salt substitutes there is an increased risk of raised blood potassium level (hyperkalaemia). These should only be used with frequent monitoring of blood potassium levels. When taken with insulin or oral antidiabetic medicines there may be an enhanced blood sugar lowering effect, resulting in very low blood sugar levels (hypoglycaemia). This is unpredictable and blood sugar should be monitored in people with diabetes starting treatment with ramipril. The use of ramipril with diuretics, ciclosporin or non-steroidal anti-inflammatory drugs (NSAIDs) may increase the risk of kidney problems and alterations to the potassium balance in the body. There may be an increased risk of a low white blood cell count (leukopenia) when ramipril is taken with allopurinol, anti-cancer medicines, medicines that suppress the immune system or corticosteroids. Regular blood monitoring is required, particularly if people taking these medicines also have decreased kidney function or collagen vascular diseases.

Other medicines containing the same active ingredients

Tritace Capsules

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