Comparative Pharmacology
Head-to-head clinical analysis: ALTACE versus RAMIPRIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALTACE versus RAMIPRIL.
ALTACE vs RAMIPRIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Angiotensin-converting enzyme inhibitor; inhibits ACE, preventing conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion.
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.
2.5-5 mg orally once daily initially, titrated to 10-20 mg once daily; maximum 20 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
Ramiprilat: 13–17 hours (prolonged in renal impairment, up to 50 hours in severe renal insufficiency; multiple doses: 45–60 hours effective half-life due to tissue binding)
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
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.
Renal: 60% (30% as ramiprilat, 30% as metabolites); Fecal: 40% (unabsorbed drug and biliary metabolites)
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."