Ramipril is a medication typically used to treat high blood pressure and other cardiovascular conditions. It is part of a family of drugs called the angiotensin-converting enzyme (ACE) inhibitors, because it blocks the action of the protein ACE, which normally constricts blood vessels and raises blood pressure. Usually, the condition that this drug is being used to treat determines the ramipril dose used for a given individual. There are other factors that can influence the dosing too, such as the presence of other medical conditions, as well as renal, or kidney, damage.
Diabetic nephropathy, or damage to the kidneys due to diabetes, is sometimes treated by this medication if a diuretic, or a medication that induces urination, is not being used. The ramipril dose for this use is 2.5 milligrams (mg) taken every day by mouth, at first. Over time, a maintenance dose is determined by a doctor that may range from 2.5 mg to 20 mg per day, divided into one or two doses. Higher doses are usually used in the event of severe symptoms or drug tolerance. A similar dose schedule is used to treat hypertension, or high blood pressure.
Congestive heart failure is another medical condition that may be treated with this drug. The usual ramipril dose for this condition is, at first, 2.5 mg taken two times a day. As a maintenance dose afterward, 5 mg is taken two times a day, by mouth.
For left ventricular dysfunction, a blood pressure condition related to the action of the left chambers of the heart, a similar dosing schedule may be used, moving from 2.5 mg per day to 5 mg per day. Additionally, this dosing schedule is used for the treatment of myocardial infarction, or a heart attack. These doses may cause hypotension, or dangerously low blood pressure, following a heart attack. In such an event, the dosage may be decreased to 1.25 mg taken once or twice a day.
Individuals with kidney damage may take somewhat lower doses of this medication. Problems with kidney function necessitate a lower ramipril dose because this medication does not clear out of the body as quickly, leaving more of the drug active in the body. Depending on certain kidney enzyme levels, a dose of 1.25 mg taken once a day may be used for some conditions. Maintenance doses are generally only increased to 5 mg per day orally. For even lower enzyme levels, the dosage used is sometimes reduced to 25 percent to 50 percent of a ramipril dose that would be given to individuals without this particular health issue.