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| {{CMG}}
| | #REDIRECT [[Ramipril#Warnings]] |
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| ===Pregnancy===
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| '''When used in pregnancy during the second and third trimesters, [[ACE inhibitor]]s can cause injury and even death to the developing fetus. When pregnancy is detected, discontinue therapy as soon as possible.'''
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| Category D (second, third trimester); Category C (first trimester).
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| Discontinue use in pregnant patients; fetal / neonatal injury and death have occurred. Closely observe infants with histories of in utero exposure.
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| ===Lactation===
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| Undetermined.
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| ===Children===
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| Safety and efficacy not established.
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| ===Elderly===
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| May show higher blood levels of active metabolite.
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| ===Renal Function===
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| Dosage reduction is required in patients with [[renal function impairment]]. May further decrease renal function with elevations in [[BUN]] and [[serum creatinine]] caused by decreased renal perfusion.
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| ===Hepatic Function===
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| Use drug with caution. Dosage reduction may be required because of impaired metabolism.
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| ===Angioedema===
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| [[Angioedema]] may occur. Use drug with extreme caution in patients with [[hereditary angioedema]].
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| ===Cough===
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| Chronic cough may occur during treatment; it is more common in women.
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| ===Hepatic failure===
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| Rarely, [[ACE inhibitor]]s have been associated with a syndrome that starts with [[cholestatic jaundice]] and progresses to [[fulminant hepatic necrosis]] and sometimes death.
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| ===Hypotension / first-dose effect===
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| Significant decreases in BP may occur following first dose, especially in severely salt- or volume-depleted patients (such as those receiving diuretics) or those with heart failure.
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| ===Neutropenia and agranulocytosis===
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| Neutropenia and agranulocytosis have occurred with similar agents; risk appears greater in presence of renal dysfunction, heart failure, or immunosuppression.
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| ===Proteinuria===
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| Proteinuria has occurred with agents in this class, especially with high doses or prior renal disease.
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| {{FDA}}
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| [[Category:Drugs]]
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