Patient Information Leaflet
Angiotensin-Converting Enzyme (ACE) Inhibitors
What are ACE Inhibitors and what are they used for?
Angiotensin-converting enzyme (ACE) inhibitors are used to treat high
blood pressure and heart failure, and in patients with diabetes to prevent
complications such as kidney disease. Some ACE inhibitors are used after
you suffer a heart attack and in coronary heart disease.
ACE inhibitors work by reducing the amount of a chemical, angiotensin-II,
that your body makes. This chemical usually causes narrowing of blood
vessels. Less of this chemical causes the blood vessels to relax and widen,
so the pressure of the blood within the blood vessels is reduced.
What is Ramipril and why was it selected as the preferred ACE inhibitor?
One of the aims of the Medicines Management Programme (MMP) is to
help GPs and prescribers choose medicines that work well and provide
value for money.
There are nine ACE inhibitors currently on the market and some are
significantly more expensive than others. Under the MMP we have
selected a ‘preferred’ ACE inhibitor, Ramipril, that we believe works very
well and will provide value for money. We are asking GPs to prescribe
ramipril when starting a patient on an ACE inhibitor and to consider
ramipril if switching the patient from another ACE inhibitor.
When deciding on the preferred ACE inhibitor many
factors were considered, some that directly affect
patients, for example:
 Side effects The preferred ACE inhibitor should
not cause more side effects than other ACE
inhibitors.
 Cost A less expensive medicine is preferred,
provided it is at least as good as the other ACE
inhibitors. Ramipril is less expensive than most
other ACE inhibitors, meaning lower out-ofpocket payments for patients who pay the full
cost of their medicines.
Dose
Ramipril is available in four strengths: 1.25 mg, 2.5 mg, 5 mg & 10 mg.
If you are taking ramipril for high blood pressure, you will usually start
on 2.5 mg once a day. If your blood pressure still remains too high,
your dose may be increased, usually by doubling the dose every twoto-four weeks, to a maximum of 10 mg a day.
If you are taking ramipril for heart failure, you may start on a lower
dose of 1.25 mg once a day. This will then be increased every few
weeks to a maximum dose of 10 mg daily. This higher dose can be
taken as a single 10 mg dose or in two split doses of 5 mg.
What side effects might I expect?
No medicine is without side effects. However, ramipril and other ACE
inhibitors generally do not cause severe side effects. You may
experience dizziness or light headedness – sometimes this happens
because of a drop in your blood pressure. Ramipril and other ACE
inhibitors can cause an irritating cough. If this happens you should tell
your doctor as he/she may consider switching you to another medicine.
A full list of side effects is given in the patient information leaflet, which
is included in every pack of medicine dispensed by your pharmacist.
What are the benefits for me?
 The Medicines Management Programme has looked at the evidence
from clinical trials and other scientific studies and is satisfied that
ramipril works well.
 Ramipril causes similar side effects to other ACE inhibitors.
 Ramipril is less expensive than most other ACE inhibitors, which can
save you and the health service money.
Version 1. May 2014