Altace (ramipril) is an angiotensin-converting enzyme (ACE) inhibitor prescription medication clinically proven to manage hypertension and reduce cardiovascular risk. It works by relaxing blood vessels, allowing blood to flow more smoothly and the heart to pump more efficiently. This medication is also indicated for patients post-heart attack to improve survival and for those at high risk of major cardiovascular events. With its well-established efficacy profile, Altace remains a cornerstone therapy in modern cardiovascular management under appropriate medical supervision.

Features

• Active ingredient: Ramipril
• Drug class: Angiotensin-converting enzyme (ACE) inhibitor
• Available in 1.25mg, 2.5mg, 5mg, and 10mg oral capsules
• Once-daily dosing formulation
• Proven 24-hour blood pressure control
• FDA-approved for hypertension, heart failure, and cardiovascular risk reduction

Benefits

• Significantly lowers both systolic and diastolic blood pressure measurements
• Reduces strain on the heart muscle and improves cardiac output
• Demonstrates proven cardiovascular protection in high-risk patients
• Decreases mortality rates following myocardial infarction
• Slows progression of kidney disease in hypertensive patients with diabetes
• Offers convenient once-daily dosing for improved adherence

Common use

Altace is primarily prescribed for the treatment of hypertension (high blood pressure) in adults. It is also approved to reduce the risk of heart attack, stroke, or death from cardiovascular causes in patients aged 55 years and older who are at high risk for these events due to a history of coronary artery disease, stroke, or peripheral vascular disease. Additionally, Altace is used in stable patients who have shown clinical signs of heart failure within the first few days after sustaining acute myocardial infarction. The medication may also be prescribed off-label for certain renal conditions in diabetic patients.

Dosage and direction

The recommended initial dosage for hypertension is 2.5mg once daily. Dosage may be increased based on blood pressure response, with maintenance doses typically ranging from 2.5mg to 20mg per day administered as a single dose or in two divided doses. For post-myocardial infarction patients, therapy should be initiated between day 3 and day 16 after infarction with a test dose of 2.5mg twice daily. If tolerated, increase to 5mg twice daily. For cardiovascular risk reduction, the initial dose is 2.5mg once daily for one week, then 5mg once daily for the next three weeks, then increased as tolerated to 10mg once daily. Altace may be taken with or without food, but consistency in administration relative to meals is recommended. Tablets should be swallowed whole with a glass of water.

Precautions

Patients should be monitored for hypotension, especially after the initial dose and during dosage adjustments. Renal function and serum potassium should be assessed prior to initiation and periodically during therapy. Angioedema may occur at any time during treatment and requires immediate discontinuation. Use with caution in patients with impaired renal function, hepatic impairment, or collagen vascular disease. Altace may cause fetal harm when administered to pregnant women, particularly during the second and third trimesters. Surgery and anesthesia may increase the hypotensive effects of Altace. Patients should avoid dehydration and excessive perspiration, which may potentiate blood pressure-lowering effects.

Contraindications

Altace is contraindicated in patients with a history of angioedema related to previous ACE inhibitor treatment. It is also contraindicated in patients with hereditary or idiopathic angioedema. Concomitant use with aliskiren-containing products is contraindicated in patients with diabetes. Do not co-administer with neprilysin inhibitors. The medication is contraindicated during pregnancy due to risk of fetal injury and death. Hypersensitivity to ramipril or any component of the formulation, or to other ACE inhibitors, represents an absolute contraindication.

Possible side effect

Common side effects include persistent dry cough (up to 20% of patients), dizziness (4-12%), headache (2-5%), fatigue (2-4%), and nausea (1-2%). Less frequently, patients may experience orthostatic hypotension, hyperkalemia, rash, impaired renal function, or taste disturbance. Serious but rare side effects include angioedema (0.1-0.5%), neutropenia/agranulocytosis, hepatic failure, and pancreatitis. The incidence of cough may be higher in women and non-smokers. Most side effects are dose-dependent and may diminish with continued therapy or dosage adjustment.

Drug interaction

Concomitant use with diuretics may potentiate hypotensive effects. Potassium supplements, potassium-sparing diuretics, or salt substitutes containing potassium may increase the risk of hyperkalemia. NSAIDs may diminish the antihypertensive effect and increase renal impairment risk. Dual blockade of the renin-angiotensin system with ARBs, aliskiren, or other ACE inhibitors increases risks of hypotension, hyperkalemia, and renal impairment. Lithium levels may increase with concomitant use. Gold injections may cause nitritoid reactions. Tetracycline absorption may be reduced. Insulin and oral hypoglycemic agents may see enhanced effects, requiring monitoring.

Missed dose

If a dose is missed, it should be taken as soon as possible on the same day. If it is near the time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Patients should maintain a consistent dosing time each day to ensure stable blood pressure control. Setting daily reminders or using pill organizers can help prevent missed doses. If multiple doses are missed, contact a healthcare provider for guidance on resuming therapy.

Overdose

Symptoms of overdose may include severe hypotension, bradycardia, circulatory shock, electrolyte disturbances, and renal failure. Laboratory findings may include hyponatremia and hyperkalemia. Management involves supportive care with volume expansion with normal saline to restore blood pressure. Hemodialysis may be effective in removing ramipril and its metabolites. Bradycardia may require atropine administration. Patients should be monitored for at least 24 hours as hypotensive effects may be prolonged. ACE inhibitor overdose can be particularly dangerous in patients with renal impairment or congestive heart failure.

Storage

Store at room temperature between 20°C to 25°C (68°F to 77°F) with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep container tightly closed and protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Do not store in bathroom cabinets where moisture levels fluctuate. Discard any medication that appears discolored or shows signs of deterioration. Proper disposal of unused medication should follow local regulations, typically through medication take-back programs.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Altace is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to medication may vary. Patients should not initiate, discontinue, or change dosage without consulting their physician. The complete prescribing information should be reviewed before initiating therapy. This summary may not include all possible information about risks, benefits, or usage conditions. Healthcare providers should exercise clinical judgment when prescribing this medication.

Reviews

Clinical studies demonstrate that Altace effectively reduces blood pressure in approximately 70-80% of patients with mild to moderate hypertension. The HOPE study showed a 22% reduction in the composite endpoint of myocardial infarction, stroke, or cardiovascular death in high-risk patients. Many patients report satisfactory blood pressure control with once-daily dosing, though the characteristic ACE inhibitor cough remains a common reason for discontinuation. Cardiologists frequently note its value in post-MI management and cardiovascular risk reduction. Patient satisfaction surveys indicate good tolerability when side effects are properly managed, though individual experiences vary significantly based on dosage and patient characteristics.