Before taking ramipril

Before taking ramipril make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you have kidney or liver problems.
• If you are on a salt restricted diet or use salt substitutes which contain potassium.
• If you have dialysis treatment.
• If you are dehydrated (for example if you have had diarrhoea and sickness very recently).
• If you have problems with circulation, for example atherosclerosis or peripheral vascular disease.
• If you have collagen vascular disease (diseases of the connective tissues), such as systemic lupus erythematosus (SLE) or scleroderma.
• If you have cardiomyopathy (cardiac muscle disease) or aortic stenosis (narrowing of the blood vessel from the heart).
• If you have a history of angioedema (where the face, tongue and throat swell).
• If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
• If you have ever had an allergic or unusual reaction to any other ACE inhibitor (this includes enalapril, lisinopril and perindopril) or to any other medicine.

How to take ramipril

• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
• Take ramipril exactly as your doctor has told you.
• It is not important whether you take ramipril before, with or after food.
• Ramipril is usually taken once a day. Try to take ramipril at the same time each day to avoid missing any doses.
• If you have been prescribed Triapin® or Triapin Mite®, swallow the tablets whole - do not crush or chew them.
• If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a missed dose.

Getting the most from your treatment

• Keep your regular appointments with your doctor so your progress can be monitored.
• Treatment with ramipril is usually life-long.
• Do not take indigestion remedies at the same time as ramipril. If you need to take an indigestion remedy, leave at least two hours before or after your dose of ramipril.
• Ramipril may cause dizziness or lightheadedness, especially the first time you take it. Make sure you know how you react to this medicine before you drive, operate machinery or do other jobs that could be dangerous if you were not fully alert.
• If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
• If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

Can ramipril cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

• Difficulty breathing, swelling of the face, mouth, tongue or throat.
• Jaundice (yellowing of the skin and whites of the eyes).
• Chest pain.
• A severe skin rash.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store ramipril

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Tritace® 1.25mg, 2.5mg, 5mg, 10mg tablets and Tritace® tablet titration pack, sanofi-aventis, electronic Medicines Compendium. Dated August 2010.
• British National Formulary; 61st Edition (March 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)