Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Apo Ramipril.
Angioedema: Ramipril may cause a serious allergic reaction called angioedema, which may be fatal if not treated promptly. If you have difficulty breathing or notice hives or swelling of the face, lips, tongue, or throat, or experience severe abdominal pain, stop taking Apo Ramipril and get emergency medical help at once. Other ACE inhibitors should not be taken in the future. People who have had angioedema caused by other substances may be at increased risk of angioedema while taking Apo Ramipril.
Blood disorders: In rare cases, a low white blood cell count has been reported with people taking Apo Ramipril. Your doctor may occasionally monitor your level of white blood cells by performing blood tests. Low white blood cell levels may increase your risk for infection. If you notice any signs of infection (e.g., fever, sore throat), contact your doctor as soon as possible.
Cough: People taking ramipril may develop a dry, persistent cough that usually disappears only after stopping or lowering the dose of ramipril.
Kidney function: Decreased kidney function or Kidney Disease can cause Apo Ramipril to build up in the body, causing side effects. Also, ramipril can cause decreases in kidney function. Certain people, such as those with narrowed blood vessels in their kidneys or severe congestive heart failure, may be more likely to experience this complication. The use of other diuretics (water pills), nonsteroidal anti-inflammatory drugs (NSAIDs), or aliskiren may further increase the risk of kidney problems.
If you have reduced kidney function or kidney disease, discuss with your doctor how Apo Ramipril may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Apo Ramipril, and whether any special monitoring is needed. People with kidney function impairment may require lower doses of Apo Ramipril. Your doctor will monitor you closely while you are taking Apo Ramipril.
Liver function: Apo Ramipril may cause liver problems. If you experience any signs of liver problems such as yellowing of the skin or eyes, fever, generally feeling unwell, abdominal pain, nausea, vomiting, loss of appetite, itching, muscle pain, rash, or swollen glands, contact your doctor immediately. People who have liver problems will need to be closely monitored by their doctor while taking Apo Ramipril.
Low blood pressure: Occasionally, blood pressure drops too low after taking ramipril. This usually happens after the first or second dose or when the dose is increased. It is more likely to occur for those who take diuretics, or the medication aliskiren, have a salt-restricted diet, are on dialysis, have diarrhea, or are vomiting. To reduce the risk of dizziness, get up slowly from a lying or sitting position. If low blood pressure causes you to faint or feel lightheaded, contact a doctor.
Potassium: Increases in blood levels of potassium can occur with use of Apo Ramipril. This rarely causes problems, but your doctor may want to monitor your potassium levels through blood tests.
Reduced alertness: Apo Ramipril may reduce alertness, especially at the beginning of treatment. Do not drive or perform tasks that require alertness until you know how Apo Ramipril affects you.
Surgery: It is important that your physician and anesthesiologist know that you are taking Apo Ramipril before you undergo any surgical procedures requiring general anesthesia.
Pregnancy: ACE inhibitors such as ramipril may cause severe harm or death to the developing baby if taken by the mother. Apo Ramipril should not be used during pregnancy. If you become pregnant while taking Apo Ramipril, stop taking it immediately and contact your doctor.
Breast-feeding: Apo Ramipril passes into breast milk. If you are a breast-feeding mother and are taking ramipril it may affect your baby. Apo Ramipril is not recommended for breast-feeding women. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Apo Ramipril have not been established for children. The use of ramipril by this age group is not recommended.
Seniors: Seniors may be more sensitive to the effects of ramipril.
