Ramipril detailed information

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Ramipril detailed information
Systematic (IUPAC) name
(1S,5S,7S)-8-[(2S)-2-[[(1S)-1-ethoxycarbonyl-3-phenyl- propyl]amino]propanoyl]-8-azabicyclo[3.3.0]octane-7- carboxylic acid
Identifiers
CAS number	87333-19-5
ATC code	C09AA05
PubChem	5362129
DrugBank	APRD00009
Chemical data
Formula	C23H32N2O5
Mol. mass	416.511 g/mol
Pharmacokinetic data
Bioavailability	28%
Protein binding	73% (ramipril) 56% (ramiprilat)
Metabolism	Hepatic, to ramiprilat
Half life	2 to 4 hours
Excretion	Renal (60%) and fecal (40%)
Therapeutic considerations
Pregnancy cat.	D
Legal status	POM(UK) ℞-only(US)
Routes	Oral

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Overview

Ramipril (marketed as Tritace/Ramace or Altace) is an angiotensin-converting enzyme (ACE) inhibitor, used to treat hypertension and congestive heart failure. ACE inhibitors lower the production of angiotensin II, therefore relaxing arterial muscles while at the same time enlarging the arteries, allowing the heart to pump blood more easily, and increasing blood flow due to more blood being pumped into and through larger passageways.

Ramipril is a prodrug and is converted to the active metabolite ramiprilat by liver esterase enzymes. Ramiprilat is mostly excreted by the kidneys. The half-life of ramiprilat is variable (3-16 hours), and is prolonged by heart and liver failure, as well as kidney failure.

Indications

Indications for its use include:

• Mild to moderate hypertension;
• Congestive heart failure;
• Following myocardial infarction in patients with clinical evidence of heart failure;
• Susceptible patients over 55 years: prevention of myocardial infarction, stroke, cardiovascular death or need of revascularization procedures.
• Also ramipril has been known to be abused as a downer

Cautions

• Do not take potassium supplements without seeking medical advice.
• Do not take during pregnancy

Contraindications

Renovascular disease, severe renal impairment (especially in patients with one kidney or with bilateral renal artery stenosis), volume-depleted patients, history of angioedema while on an ACE inhibitor, pregnancy, hypotension.

Side-effects

• may cause swelling of the mouth, tongue, or throat
• low blood sugar in patients taking other medicine for diabetes which shows as sweating or shakiness
• persistent dry cough, dizziness, and light-headedness due to low blood pressure.

Dose

• 2.5 to 20 mg per day
• initial dose of 1.25mg per day

See also

• Hypertension
• Heart failure

External links

• Altace (ramipril), a registered trademark of King Pharmaceuticals, Inc.

v • d • e Agents acting on the renin-angiotensin system (C09)
ACE inhibitors	Benazepril • Captopril • Delapril • Enalapril • Fosinopril • Imidapril • Lisinopril • Moexipril • Perindopril • Quinapril • Ramipril • Spirapril • Temocapril • Trandolapril • Zofenopril
Angiotensin II receptor antagonists (AIIRA)	Candesartan • Eprosartan • Irbesartan • Losartan • Olmesartan • Tasosartan • Telmisartan • Valsartan
Renin inhibitors	Aliskiren • Remikiren

de:Ramipril

hr:Ramipril

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .