![]() The only ACE inhibitors in New Zealand currently licensed for use in children are lisinopril, captopril, and enalapril. Ramipril is not approved for use in those younger than 18 years old. If serum potassium rises to greater than 5.9mmol/L the drug should be stopped.įor an extensive list of side effects see the New Zealand Formulary (NZF) monograph on ramipril, ‘adverse effects’ section. If creatinine rises more than 30% from previous baseline, or eGFR drops by more than 25%, the dose should be reduced or stopped and other causes for decline investigated. It is likely that serum creatinine will slightly rise after starting an ACE inhibitor. If this isn’t possible, consider a lower initial dose of 1.25mg. To avoid this initial drop in those on diuretics, the diuretic may be withheld for 2-3 days prior to starting then re-introduced. This can occur with the first dose and with escalating doses, and particular caution is needed in those also on diuretic medications or who are volume deplete. If cough is troublesome on one ACE inhibitor, changing to a different anti-hypertensive class may be required.Īlternatively, a change in anti-hypertensive class may be required. Cough is generally a class effect of all ACE inhibitors. This is more common in women, and often worse lying down and/or at night. This is the most common side effect of any ACE, experienced by around 11% of patients. ![]() Ramipril shares common side effects, cautions, contraindications, and interactions with all other ACE inhibitors. ![]()
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