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| {{drugbox
| | #REDIRECT [[Ramipril#Pharmacology]] |
| | IUPAC_name = (1''S'',5''S'',7''S'')-8-[(2''S'')-2-<nowiki>[[</nowiki>(1''S'')-1-ethoxycarbonyl-3-phenyl-<br>propyl]amino]propanoyl]-8-azabicyclo[3.3.0]octane-7-<br>carboxylic acid
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| | image = Ramipril_svg.png
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| | CAS_number = 87333-19-5
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| | ATC_prefix = C09
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| | ATC_suffix = AA05
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| | ATC_supplemental =
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| | PubChem = 5362129
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| | DrugBank = APRD00009
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| | C = 23 | H = 32 | N = 2 | O = 5
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| | molecular_weight = 416.511 g/mol
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| | bioavailability = 28%
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| | protein_bound = 73% (ramipril)<br>56% (ramiprilat)
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| | metabolism = [[Liver|Hepatic]], to ramiprilat
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| | elimination_half-life = 2 to 4 hours
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| | excretion = [[Kidney|Renal]] (60%) and fecal (40%)
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| | pregnancy_category = D
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| | legal_UK = POM
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| | legal_US = Rx-only
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| | routes_of_administration = Oral
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| }}
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| {{CMG}}
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| ==[[Ramipril (patient information)|For patient information, click here]]==
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| ==Overview==
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| '''Ramipril''' (marketed as '''Tritace/Ramace''' or '''Altace''') is an [[ACE inhibitor|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.
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| Ramipril is a [[prodrug]] and is converted to the active [[metabolite]] ramiprilat by [[liver]] [[esterase]] [[enzyme]]s. Ramiprilat is mostly [[excretion|excreted]] by the [[kidney]]s. The [[half-life]] of ramiprilat is variable (3-16 hours), and is prolonged by heart and [[liver failure]], as well as [[renal failure|kidney failure]].
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| ==Indications==
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| Indications for its use include:
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| *Mild to moderate [[hypertension]];
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| *[[Congestive heart failure]];
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| *Following [[myocardial infarction]] in patients with clinical evidence of [[heart failure]];
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| *Susceptible patients over 55 years: prevention of myocardial infarction, [[stroke]], cardiovascular death or need of [[revascularization]] procedures.
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| *Also ramipril has been known to be abused as a downer
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| ==Cautions==
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| *Do not take potassium supplements without seeking medical advice.
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| *Do not take during pregnancy
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| ==Contraindications==
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| 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.
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| ==Side-effects==
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| *may cause swelling of the mouth, tongue, or throat
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| *low blood sugar in patients taking other medicine for diabetes which shows as sweating or shakiness
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| *persistent dry cough, dizziness, and light-headedness due to low blood pressure.
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| ==Dose==
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| *2.5 to 20 mg per day
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| *initial dose of 1.25mg per day
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| ==See also==
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| *[[Hypertension]]
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| *[[Heart failure]]
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| ==External links==
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| *[http://www.altace.com Altace (ramipril)], a registered trademark of [[King Pharmaceuticals]], Inc.
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| {{ACE inhibitors}}
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| [[Category:ACE inhibitors]]
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| [[Category:Prodrugs]]
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| [[Category:Drugs]]
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| [[de:Ramipril]]
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| [[hr:Ramipril]]
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