Ramipril Drug Interactions
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Severity level | Drug and description of interaction |
| 4 (Very High) | Hymenoptera Venom, treatment with ACE inhibitors may increase the risk of anaphylactoid reaction in patients undergoing desensitization procedures. [1] |
| 3 (High) | Azathioprine, a rare toxicity associated with ACE inhibitors includes neutropenia/agranulocytosis with myeloid hyperplasia; [2] Potassium Salts- ACE inhibitors may increase blood levels of potassium, the use of potassium supplements, salt substitutes (which often contain potassium), or other drugs that increase the body's potassium may result in excessive blood potassium levels. [3] |
| 2 (Moderate) | MAOI's- may cause excessive hypotension; [4] Heparin- may cause elevated levels of serum potassium; [5] Alcohol- may cause excessive hypotension and severe dizziness; [6]Aspirin- may have a counteracting effect to ACE inhibitors leading to hypertension; [7] Lithium- decreases renal elimination of lithium; [8] Diuretics- can cause very low blood pressure in patients treated with both therapies; [6] NSAIDs-some evidence suggests that coadministration is linked to worsening of renal failure and an increase in serum potasssium levels; [6]
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| 1 (low) | drospirenone-may increase serum potassium levels [6] |
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Drug-food/drug-herb interactions
| Severity level | Drug and description of interaction |
| 4 | None known |
| 3 | Potassium Salts- ACE inhibitors may increase blood levels of potassium, the use of potassium supplements, salt substitutes (which often contain potassium), or other drugs that increase the body's potassium may result in excessive blood potassium levels. [3] |
| 2 | Hawthorne (Crataegus monogyna)- May cause hypotension [9] |
| 1 | None known |
- ↑ Stumpf J. Safety of Angiotensin-Converting Enzyme Inhibitors in Patients with Insect Venom Allergies. The Annals of Pharmacotherapy:40(4)699-703.
- ↑ ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group, "Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)," JAMA, 2002, 288(23):2981-97.
- ↑ 3.0 3.1 Mann JF, Yi QL, Sleight P, Dagenais GR, Gerstein HC, Lonn EM, Bosch J; HOPE Investigators. Serum potassium, cardiovascular risk, and effects of an ACE inhibitor: results of the HOPE study. Clin Nephrol. 2005 Mar;63(3):181-7.
- ↑ Smith MS, Muir H, Hall R. Perioperative management of drug therapy, clinical considerations. Drugs. 1996 Feb;51(2):238-59.
- ↑ Indermitte J, Burkolter S, Drewe J, Krähenbühl S, Hersberger KE. Risk factors associated with a high velocity of the development of hyperkalaemia in hospitalised patients. Drug Saf. 2007;30(1):71-80.
- ↑ 6.0 6.1 6.2 6.3 Altace [package insert]. Bristol, TN: Monarch Pharmaceuticals; September 2005.
- ↑ Peterson JG, Topol EJ, Sapp SK, Young JB, Lincoff AM, Lauer MS. Evaluation of the effects of aspirin combined with angiotensin-converting enzyme inhibitors in patients with coronary artery disease. Am J Med. 2000 Oct 1;109(5):371-7.
- ↑ Imbs JL, Barthelmebs M, Danion JM, Singer L. Mechanisms of drug interactions with renal elimination of lithium. Bull Acad Natl Med. 1997 Apr;181(4):685-95; discussion 695-7.
- ↑ Lacaille-Dubois , Franck U, Wagner H. Search for potential angiotensin converting enzyme (ACE)-inhibitors from plants. Phytomedicine. 2001 Jan;8(1):47-52.
