Ramipril Side Effects

by on January 10, 2012


Side effects of Ramipril (Altace) are typically mild and do not occur in the majority of patients taking it. The most common side effects are dizziness and nausea. These are typically manageable with minor changes to the patient’s lifestyle, diet and habits. More serious side effects of ramipril can include fainting, chest pain, severe swelling or symptoms of liver problems. If you experience any adverse side effects with this medication, you should report them to your doctor immediately for evaluation and further treatment.

Common Ramipril Side Effects

Ramipril side effects are very rare. Most patients find they are able to manage their side effects without stopping the treatment. The most commonly reported include the following:

  • Headache
  • Drowsiness
  • Dizziness
  • Insomnia
  • Cough
  • Nausea
  • Vomiting
  • Itching
  • Rash
  • Body weakness
  • Low blood pressure
  • Chest pains
  • Vertigo

In most cases, side effects will gradually go away as the body adjusts to the medication. If you notice your side effects worsening, persisting or interfering significantly with your day to day activities, you should consult your doctor. You may be able to solve these issues by adjusting the dosage of the medication.

Serious Ramipril Side Effects


Though rare, some patients can be allergic to this treatment. If you believe you are experiencing an allergic reaction, it is important to contact your doctor immediately. Symptoms of a drug allergy can worsen quickly. The following side effects may indicate an allergic reaction:

  • Itching
  • Rash or hives
  • Tightness of the chest
  • Swelling of the face or throat
  • Difficulty breathing

Other serious Ramipril side effects that are not related to an allergic reaction may occur. These should be brought to the attention of a healthcare provider.

  • Yellowing of the eyes or skin
  • Dark-colored urine
  • Severe abdominal pain
  • Persistent nausea or vomiting
  • Fainting
  • Muscle weakness
  • Fever
  • Sore throat
  • Chills
  • Swelling of the head, neck, feet or hands
  • Unusual skin conditions including rash, itching, peeling or blisters
  • Decreased urine production
  • Uneven or pounding heartbeats
  • Slow heart rate
  • Chest pain
  • Rapid weight gain


Side effects in pregnancy are severe and can be fatal to the unborn baby. It is essential that you take the appropriate steps to prevent pregnancy while taking this medication. Your doctor will be able to provide you with detailed information on the best and safest ways to prevent pregnancy. If you believe that you are pregnant, contact your doctor immediately.

Interactions With Other Medications

Side effects may occur in conjunction with other medications. In most cases, Ramipril reduces the effectiveness of these medications. Consult your doctor if you are taking these drugs as your dosage will need to be adjusted accordingly. Medications associated with Ramipril side effects include the following:

  • Angiotensen II receptor blockers (ARBs)
  • Injectable gold
  • Nonsteroidal ant-inflammatory drugs (NSAIDs) such as Aspirin, Ibuprofen, Aleve, and Celebrex
  • Diuretics
  • Lithium
  • Potassium-sparing diuretics
  • Potassium-containing medications
  • Telmisartan

Insect Stings

If you are stung by a wasp or bee, it is important to let your doctor, or any individual treating you, know that you are taking ramipril. The sting itself will not cause any side effects.  However, the injection provided for a bee or wasp allergy can result in a serious reaction. Always let your healthcare provider know what medications you are already taking before you allow them to prescribe more.


Dizziness is very common among side effects experienced by patients taking Ramipril. When first starting this medication, you should not drive or operate heavy machinery until you are able to evaluate how ramipril medications will affect you.

Use alcoholic beverages in moderation as these will only intensify such side effects. To control and reduce dizziness, rise slowly and move to a sitting position first before you get up when lying down. Dizziness is more pronounced in older patients than in younger ones.


Nausea and vomiting are two of the more common side effects that patients report. One of the greatest hazards with these side effects is the potential for dehydration. Be sure to drink plenty of fluids even if you feel nauseous. Replenish your fluids diligently if you are experiencing vomiting. Dehydration will intensify dizziness associated with ramipril and may perpetuate the cycle of nausea and vomiting.

Ramipril (Altace) is typically very effective for treating conditions associated with high blood pressure. For the majority of patients, side effects are mild and very manageable. The most important consideration on this medication is avoiding pregnancy. Most other side effects of ramipril and Altace will not affect patients taking the drug in a significant way.