Altace

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Altace (Ramipril). If you are concerned about side effects, discuss the risks and benefits of Altace (Ramipril) with your doctor.

The following side effects have been reported by at least 1% of people taking Altace (Ramipril). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• change in sense of taste
• cough (dry, persistent)
• dizziness or lightheadedness
• drowsiness
• eye redness, inflammation
• fatigue
• flushing
• hair loss
• headache
• inflammation of the mouth or tongue
• nasal congestion
• sexual difficulties
• weakness

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• balance problems
• chest pain
• Fever, muscle pain, rash, or swollen glands that occur in the first few weeks or month of treatment
• hearing changes
• increased Asthma symptoms (e.g., shortness of breath, trouble breathing)
• low blood pressure (dizziness or lightheadedness, especially when rising from a lying or sitting position)
• signs of bleeding (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of electrolyte imbalance (e.g., muscle pain or cramps, weakness, irregular heart beat)
• signs of infection (symptoms may include fever or chills, severe Diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine)
• signs of liver problems (abdominal pain, abdominal distention, fever, nausea, or vomiting, yellowing of the skin or eyes)
• signs of changed potassium levels (e.g., irregular heartbeat, muscle weakness, general feeling unwell)
• skin irritation
• skin rash with or without itching, fever, or joint pain
• swelling of the hands, feet, or ankles
• vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

• abdominal pain, with or without nausea or vomiting
• signs of an allergic reaction, including angioedema (shortness of breath or difficulty breathing; Hives; swelling of the eyes, mouth, lips, or throat)
• symptoms of a heart attack (pain, pressure, tightness or heaviness in the chest, jaw, neck or shoulder, sweating, or shortness of breath)
• symptoms of a stroke (sudden numbness or weakness, especially on one side of the body; sudden confusion, trouble speaking, or difficulty understanding speech; sudden problems with coordination or balance; sudden vision problems in one or both eyes; sudden, severe headache with no other cause)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Altace (Ramipril).

1.25 mg
Each size "4" hard gelatin capsule with white opaque body imprinted with "Altace" and yellow opaque cap imprinted with "1.25" contains 1.25 mg of Altace (Ramipril). Nonmedicinal ingredients: pregelatinized starch; capsule: gelatin, titanium dioxide, and yellow iron oxide.

2.5 mg
Each size "4" hard gelatin capsule with white opaque body imprinted with "Altace" and orange opaque cap imprinted with "2.5" contains 2.5 mg of Altace (Ramipril). Nonmedicinal ingredients:pregelatinized starch; capsule: FD&C Red No. 3, gelatin, titanium dioxide, and yellow iron oxide.

5 mg
Each size "4" hard gelatin capsule with white opaque body imprinted with "Altace" and red opaque cap imprinted with "5" contains 5 mg of Altace (Ramipril). Nonmedicinal ingredients: pregelatinized starch; capsule: FD&C Blue No. 2, FD&C Red No. 3, gelatin, and titanium dioxide.

10 mg
Each size "4" hard gelatin capsule with white opaque body imprinted with "Altace" and blue opaque cap imprinted with "10" contains 10 mg of Altace (Ramipril). Nonmedicinal ingredients: pregelatinized starch; capsule: black iron oxide, FD&C Blue No. 2, FD&C Red No. 3, gelatin, and titanium dioxide.

15 mg
Each size "3" hard gelatin capsule with grey opaque body imprinted with "Altace" and powder blue opaque cap imprinted with "15" contains 15 mg of Altace (Ramipril). Nonmedicinal ingredients: pregelatinized starch; capsule: black iron oxide, D&C Red No. 28, FD&C Blue No. 1, gelatin, and titanium dioxide.

Do not take Altace (Ramipril) if you:

• are allergic to Altace (Ramipril), or any other ACE inhibitor, or any ingredients of the medication
• are breast-feeding
• are pregnant
• have had angioedema (a serious allergic reaction which causes the area around the throat and tongue to swell)
• have been diagnosed with hereditary angioedema
• have low blood pressure
• have narrowing of the blood vessels to the kidneys
• are taking the medication sacubitril-valsartan
• are taking the medication Aliskiren or angiotensin II receptor antagonists and have
• Diabetes
• moderate to severely decreased kidney function
• high levels of potassium in the blood
• Congestive Heart Failure with low blood pressure
• are receiving dialysis or other similar treatments

There may be an interaction between Altace (Ramipril) and any of the following:

• acetylsalicylic acid (Asa)
• Aldesleukin
• aliskiren
• allergy shots for bee or wasp stings
• Allopurinol
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• amifostine
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• other angiotensin converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Altace (Ramipril))
• angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• atypical antipsychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• Azathioprine
• barbiturates (e.g., Phenobarbital, butalbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• brimonidine
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• ciprofloxacin
• conivaptan
• Cyclosporine
• diuretics (water pills; e.g., Furosemide, Amiloride, Spironolactone, triamterene)
• drospirenone
• Duloxetine
• Everolimus
• "gliptin" diabetes medications (e.g., Linagliptin, Saxagliptin, Sitagliptin)
• gold injections (sodium aurothiomalate)
• grass pollen extract
• Guanfacine
• Heparin
• insulin
• iron dextran
• iron supplements
• levodopa
• lithium
• low-molecular-weight heparins (e.g., Dalteparin, Tinzaparin)
• Methylphenidate
• Minoxidil
• mycophenolate
• narcotic medications (e.g., Codeine, Morphine)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., Indomethacin, Naproxen)
• Obinutuzumab
• oral diabetes medications (e.g., Canagliflozin, Glyburide, Gliclazide, Metformin, Pioglitazone, saxagliptin)
• Pentoxifylline
• phosphodiesterase-5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• Pregabalin
• procainamide
• quinine
• sacubitril
• Selegiline
• Sirolimus
• sodium phosphates
• substances that increase potassium levels (e.g., potassium chloride, salt substitutes containing potassium)
• Temsirolimus
• Tizanidine
• Tolvaptan
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Trimethoprim
• Yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Altace (Ramipril). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Altace (Ramipril).

Angioedema: Altace (Ramipril) may cause a serious allergic reaction called angioedema, which may be fatal if not treated promptly. If you have difficulty breathing or notice hives or swelling of the face, lips, tongue, or throat, or experience severe abdominal pain, stop taking Altace (Ramipril) and get emergency medical help at once. Other ACE inhibitors should not be taken in the future. People who have had angioedema caused by other substances may be at increased risk of angioedema while taking Altace (Ramipril).

Blood disorders: In rare cases, a low white blood cell count has been reported with people taking Altace (Ramipril). Your doctor may occasionally monitor your level of white blood cells by performing blood tests. Low white blood cell levels may increase your risk for infection. If you notice any signs of infection (e.g. fever, sore throat), contact your doctor as soon as possible.

Cough: People taking Altace (Ramipril) may develop a dry, persistent cough that usually disappears only after stopping or lowering the dose of Altace (Ramipril).

Kidney function: Decreased kidney function or Kidney Disease can cause Altace (Ramipril) to build up in the body, causing side effects. Also, Altace (Ramipril) can cause decreases in kidney function. Certain people, such as those with narrowed blood vessels in their kidneys or severe congestive heart failure, may be more likely to experience this complication. The use of other diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase risk of kidney problems.

If you have reduced kidney function or kidney disease, discuss with your doctor how Altace (Ramipril) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Altace (Ramipril), and whether any special monitoring is needed. People with kidney function impairment may require lower doses of Altace (Ramipril).

Liver function: Altace (Ramipril) may cause liver problems. If you experience any signs of liver problems such as yellowing of the skin or eyes, fever, generally feeling unwell, abdominal pain, nausea, vomiting, loss of appetite, itching, muscle pain, rash, or swollen glands, contact your doctor immediately. If you have liver problems, you will need to be closely monitored by your doctor while taking Altace (Ramipril).

Low blood pressure: Occasionally, blood pressure drops too low after taking Altace (Ramipril). This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take diuretics, or the medication aliskiren, have a salt-restricted diet, are on dialysis, have diarrhea, or are vomiting. To reduce the risk of dizziness, get up slowly from a lying or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact a doctor.

Potassium: Increases in blood levels of potassium can occur with use of Altace (Ramipril). This rarely causes problems, but your doctor may want to monitor your potassium levels through blood tests.

Reduced alertness: Altace (Ramipril) may reduce alertness, especially at the beginning of treatment. Do not drive or perform tasks that require alertness until you know how Altace (Ramipril) affects you.

Surgery: It is important that your physician and anesthesiologist know that you are taking Altace (Ramipril) before you undergo any surgical procedures requiring general anesthesia.

Pregnancy: ACE inhibitors such as Altace (Ramipril) may cause severe harm or death to the developing baby if taken by the mother during pregnancy. Altace (Ramipril) should not be used during pregnancy. If you become pregnant while taking Altace (Ramipril), stop taking it immediately and contact your doctor.

Breast-feeding: Altace (Ramipril) passes into breast milk. If you are a breast-feeding mother and are taking Altace (Ramipril) it may affect your baby. Altace (Ramipril) is not recommended for breast-feeding women. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Altace (Ramipril) have not been established for children. The use of Altace (Ramipril) by this age group is not recommended.