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ACE Inhibitor·Cardiovascular - Antihypertensives
Hypertension, Heart Failure (HFrEF, post-MI), secondary prevention of MI and stroke in high-risk CV patients, diabetic nephropathy
Max Dose
10 mg/day
Half-life
13-17 h (Active)
Dry Cough
COMMON
Teratogenic
CRITICAL RISK
Overview
Potent, long-acting Angiotensin-Converting Enzyme (ACE) inhibitor. Cornerstone foundational therapy for hypertension, heart failure post-MI, diabetic nephropathy, and secondary cardiovascular prevention (HOPE trial).
Maximum Dose
Max 10 mg/day. Reduce in Renal impairment — initial 1.25 mg OD, max 5 mg/day if eGFR < 30.
Clinical Focus
Absolutely contraindicated in Pregnancy (Category D). Causes severe fetal renal dysgenesis, oligohydramnios, and neonatal hypoplasia. Cease immediately on confirmed pregnancy.
Bottom Line
Ramipril is a high-yield first-line ACE inhibitor with extensive clinical trial evidence for stroke and MI risk reduction, but must never be used in Pregnancy and mandates baseline and ongoing U&E monitoring.
Brand Names
Tritace, Ramace, Prilace
Oral Routes
Tablets / Capsules (1.25 mg, 2.5 mg, 5 mg, 10 mg).
Prescribing & PBS
Unrestricted General Benefit (S4).
Primary
Hypertension, Heart Failure (HFrEF, post-MI), secondary prevention of MI and stroke in high-risk CV patients, diabetic nephropathy.
Clinical Place
First-line ACE inhibitor supported by landmark trial evidence (HOPE study) demonstrating mortality and CV event reduction.