Altace (ramipril) is an angiotensin-converting enzyme (ACE) inhibitor prescribed for the management of hypertension, heart failure, and post-myocardial infarction care. It functions by relaxing blood vessels, facilitating easier blood flow, and reducing the heart’s workload. This medication is a cornerstone in preventive cardiology, particularly for patients at high risk of major cardiovascular events. Clinical evidence supports its efficacy in not only controlling blood pressure but also in improving survival rates following heart attacks and in patients with clinical evidence of heart failure.

Features

• Active ingredient: Ramipril
• Available in 1.25 mg, 2.5 mg, 5 mg, and 10 mg oral capsules
• Belongs to the angiotensin-converting enzyme (ACE) inhibitor class
• Once-daily dosing for most indications
• Proven to reduce the risk of stroke, myocardial infarction, or death from cardiovascular causes
• Suitable for use in adult and geriatric populations, with dose adjustments for renal impairment

Benefits

• Effectively lowers high blood pressure, reducing strain on the heart and arteries.
• Decreases the risk of heart attack, stroke, and cardiovascular-related mortality.
• Improves survival rates in patients with heart failure post-myocardial infarction.
• Helps protect kidney function in hypertensive patients with diabetes.
• May slow the progression of atherosclerosis and other vascular complications.
• Enhances overall quality of life by mitigating symptoms associated with hypertension and cardiac issues.

Common use

Altace is commonly prescribed for the treatment of essential hypertension. It is also indicated to reduce the risk of myocardial infarction, stroke, or death from cardiovascular causes in patients at high risk, such as those with a history of coronary artery disease, stroke, or peripheral vascular disease. Additionally, it is used in the management of congestive heart failure post-myocardial infarction and for nephropathy protection in diabetic patients.

Dosage and direction

The dosage of Altace must be individualized based on the patient’s clinical condition and response. For hypertension, the usual starting dose is 2.5 mg once daily, which may be titrated up to a maximum of 10 mg daily. In heart failure post-myocardial infarction, initiation at 2.5 mg twice daily is recommended, with careful uptitration. For cardiovascular risk reduction, 2.5 mg daily is often started, increasing as tolerated. Altace should be taken orally, with or without food, at approximately the same time each day to maintain consistent blood levels. Dosage adjustments are necessary for patients with renal impairment.

Precautions

Patients should be monitored for hypotension, especially after the initial dose or dosage increases. Renal function and serum potassium levels should be assessed periodically, as Altace can affect both. Use with caution in patients with renal artery stenosis, as it may worsen renal function. Angioedema has been reported with ACE inhibitors; discontinue immediately if symptoms such as swelling of the face, lips, or tongue occur. Avoid use during pregnancy due to potential fetal harm. Patients should report any signs of infection, such as sore throat or fever, as neutropenia/agranulocytosis has been observed.

Contraindications

Altace is contraindicated in patients with a history of angioedema related to previous ACE inhibitor therapy. It should not be used in patients with hereditary or idiopathic angioedema. Concomitant use with aliskiren in patients with diabetes is contraindicated. Avoid use in patients with bilateral renal artery stenosis. Altace is also contraindicated during the second and third trimesters of pregnancy.

Possible side effect

Common side effects may include dizziness, cough, hyperkalemia, headache, and fatigue. Less frequently, patients may experience orthostatic hypotension, rash, gastrointestinal disturbances such as nausea or diarrhea, and taste disturbance. Serious side effects, though rare, can include angioedema, neutropenia/agranulocytosis, hepatic failure, and renal impairment. Patients should seek medical attention if they experience symptoms of these serious adverse reactions.

Drug interaction

Altace may interact with diuretics, increasing the risk of hypotension. Concurrent use with potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium can lead to hyperkalemia. NSAIDs may reduce the antihypertensive effect and increase the risk of renal dysfunction. Lithium levels may increase with concomitant use. Dual blockade of the renin-angiotensin system with ARBs or aliskiren increases risks of hypotension, hyperkalemia, and renal impairment.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose to make up for a missed one is not recommended.

Overdose

Symptoms of overdose may include severe hypotension, bradycardia, circulatory shock, hyperkalemia, renal failure, and electrolyte imbalances. Management involves supportive measures, such as intravenous fluids and vasopressors for hypotension, and hemodialysis may be considered. Gastric lavage or activated charcoal may be appropriate if ingestion was recent.

Storage

Store Altace capsules at room temperature, between 20°C to 25°C (68°F to 77°F), in a tightly closed container, away from light and moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult a healthcare professional for diagnosis and treatment tailored to your individual health needs. Do not alter your dosage or discontinue Altace without medical supervision.

Reviews

Clinical studies and patient reports generally reflect positive outcomes with Altace, particularly in cardiovascular risk reduction and hypertension management. Many users note effective blood pressure control and a sense of improved cardiovascular health. However, some report the persistent dry cough associated with ACE inhibitors. Adherence to prescribed regimens and regular follow-ups are emphasized for optimal results.