User:JustinxLane/Ramipril

Significant adverse effects

 * Acute kidney injury (1% incidence) - This medication may increase blood urea nitrogen and creatinine levels, which has the chance of causing kidney injury. patients more susceptible to this are: Patients starting at a higher dose, Older patients, patients with preexisting kidney damage, patients with congestive heart failure, patients with low blood volumes, patients with hypotension and patients with renal artery stenosis.


 * Angioedema (less than 1% incidence) - This is one of the rarer adverse effects; it may lead to fluid buildup in the head and neck and sometimes the intestines (intestinal fluid buildup presents as abdominal pain). This medication would be contraindicated if patients have a history of idiopathic angioedema or have had it in response to an ACE inhibitor.
 * Cough (8 - 12% incidence) - This presents as a dry hacking cough and may have an onset of hours to 6 months after initiation. If this adverse effect is troublesome, you can consult your doctor about switching to a similar agent without the incidence of a cough. After discontinuing this medication, the cough may persist for up to 3 months.
 * Hyperkalemia (1% incidence) - This is an increase in potassium levels which can be troublesome if increased too much. For this reason, your doctor will often follow up with you in about 2-4 weeks after initiating this agent to ensure these levels are where they should be.

Other adverse effects

 * Hypotension (11% incidence)
 * Nausea and vomiting (2% incidence) - If you experience this, it can be mitigated by taking this medication with food
 * Dizziness (2 - 4% incidence)

Special populations

 * Black patients - Studies have shown that ACE inhibitors may be less effective at decreasing blood pressure in this population.
 * Surgical patients - When ace inhibitors are taken close to surgery, hypotension can develop. However, due to the drug's beneficial nature, discontinuing it before surgery is controversial. The recommendation is for the team treating you to be aware of this risk and monitor closely to ensure your safety.
 * Older adults - There should be additional monitoring due to the increased risk of hypotension.
 * Pregnant patients - Use is contraindicated since it increases the risk of fetal malformations.