Ramipril is a medication from a group of drugs called ACE inhibitors that is used to treat high blood pressure, heart failure, and diabetic kidney disease. It is also used to prevent cardiovascular disease in people at high risk. It is a useful first-line treatment for high blood pressure. It is taken by mouth and requires a prescription.



Ramipril inhibits the RAAS system by binding to and inhibiting ACE, thereby preventing the conversion of angiotensin I to angiotensin II. As plasma levels of angiotensin II decrease, there is less activation of the G-protein-coupled angiotensin receptors AT1 and AT2. AT1 in particular is involved in processes that increase blood pressure, which is why patients with persistently elevated blood pressure benefit from ACE inhibition.


Ramipril is approximately 60% absorbed in the gastrointestinal tract. Plasma protein binding of ramipril is approximately 73%. Ramipril is metabolized in the liver and 60% is excreted in the urine and 40% in the stool. The elimination half-life is 9-18 hours.

Drug Interactions

Some products that may interact with this drug are:

  • Aliskiren
  • medicines that weaken the immune system/increase the risk of infection (like everolimus, sirolimus)
  • lithium
  • medicines that can increase blood potassium levels (like ARBs including losartan/valsartan, birth control pills that contain drospirenone)
  • Sacubitril
  • Telmisartan

Some products have ingredients that may increase your blood pressure or worsen your heart failure: especially cough and cold medicines, diet medicines, or NSAIDs such as ibuprofen/naproxen.


Side effects

Common side effects are headache, dizziness, tiredness and cough.

Serious side effects may include liver problems, angioedema, kidney problems, and high blood potassium.

Use during pregnancy and lactation is not recommended.

Toxicological data

LD50 (rat, i.v.): 600 mg-kg-1

Chemical & physical properties

ATC Code C09AA05
Formula C23H32N2O5
Molar Mass (g·mol−1) 416,51
Physical State solid
Melting Point (°C) 109
PKS Value 3.74
CAS Number 87333-19-5
PUB Number 5362129
Drugbank ID DB00178


  • Drugbank
  • PubChem
  • WebMD
  • Aktories, Förstermann, Hofmann, Starke: Allgemeine und spezielle Pharmakologie und Toxikologie, Elsvier, 2017

Editorial principles

All information used for the content comes from verified sources (recognised institutions, experts, studies by renowned universities). We attach great importance to the qualification of the authors and the scientific background of the information. Thus, we ensure that our research is based on scientific findings.
Markus Falkenstätter, BSc

Markus Falkenstätter, BSc

Markus Falkenstätter is a writer on pharmaceutical topics in Medikamio's medical editorial team. He is in the last semester of his pharmacy studies at the University of Vienna and loves scientific work in the field of natural sciences.

Mag. pharm. Stefanie Lehenauer

Mag. pharm. Stefanie Lehenauer

Stefanie Lehenauer has been a freelance writer for Medikamio since 2020 and studied pharmacy at the University of Vienna. She works as a pharmacist in Vienna and her passion is herbal medicines and their effects.

The content of this page is an automated and high-quality translation from DeepL. You can find the original content in German here.


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