The following section describes in detail the interactions that can occur when
ramipril is combined with other substances.
Diuretics
If you are taking ramipril with a diuretic, your
blood pressure may decrease too much. You can reduce the risk of this happening by either stopping the diuretic (under a healthcare provider's supervision) or increasing salt intake prior to starting the ramipril. Discuss these options more with your healthcare provider.
Injectable Gold
Reactions have been reported in people taking ramipril who received gold injections. These reactions included symptoms such as facial flushing, nausea, vomiting, and low blood pressure.
Lithium
Ramipril may increase the risk of
lithium toxicity and may increase the
lithium levels in the blood. Your healthcare provider may choose to monitor your blood lithium levels more frequently and may need to adjust your
lithium dosage.
Nonsteroidal Anti-Inflammatory Drugs
If you have kidney disease or kidney failure, taking both
NSAIDs (such as
ibuprofen) and ramipril may add to the damage your kidneys are already suffering. Your healthcare provider may choose to monitor your progress closely.
Potassium
If you are taking a potassium product together with ramipril, the levels of potassium in your blood may become too high. This can cause serious problems. For your particular situation, talk to your healthcare provider about using potassium and ramipril together.
Potassium-Sparing Diuretics
If you are taking ramipril and a potassium-sparing diuretic, your blood pressure may decrease too much and/or the levels of potassium in your blood may become too high. Your healthcare provider may choose to monitor your progress closely.