Comparative Pharmacology
Head-to-head clinical analysis: ACCUPRIL versus RAMIPRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACCUPRIL versus RAMIPRIL.
ACCUPRIL vs RAMIPRIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Angiotensin-converting enzyme (ACE) inhibitor; inhibits ACE, thereby blocking conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion, leading to decreased blood pressure.
Ramipril is a prodrug that is hydrolyzed in the liver to its active metabolite ramiprilat, which inhibits angiotensin-converting enzyme (ACE), thereby decreasing angiotensin II production, reducing vasoconstriction, aldosterone secretion, and sodium retention.
10-40 mg orally once daily; initial dose 10 mg, titrate to target dose based on blood pressure response; maximum 80 mg/day.
Initial: 2.5 mg orally once daily; Maintenance: 2.5-20 mg/day in 1-2 divided doses; Maximum: 20 mg/day.
None Documented
None Documented
Clinical Note
moderateRamipril + Torasemide
"The risk or severity of adverse effects can be increased when Ramipril is combined with Torasemide."
Clinical Note
moderateRamipril + Etacrynic acid
"The risk or severity of adverse effects can be increased when Ramipril is combined with Etacrynic acid."
Clinical Note
moderateRamipril + Furosemide
"The risk or severity of adverse effects can be increased when Ramipril is combined with Furosemide."
Clinical Note
moderateRamipril + Bumetanide
Quinaprilat terminal elimination half-life is approximately 3 hours. In patients with renal impairment (CrCl <30 mL/min), half-life can be prolonged up to 10-25 hours, requiring dose adjustment.
Terminal half-life of ramiprilat is 13–17 hours (prolonged to 50 hours in renal impairment). Accumulation half-life is 110 hours after multiple doses.
Primarily renal (about 60% as unchanged drug and 40% as metabolites, mainly quinaprilat), with biliary/fecal elimination accounting for less than 10%.
Primarily renal (60% as unchanged drug and metabolites) and fecal (40% via biliary elimination).
Category C
Category D/X
ACE Inhibitor
ACE Inhibitor
"The risk or severity of adverse effects can be increased when Ramipril is combined with Bumetanide."