Comparative Pharmacology
Head-to-head clinical analysis: RAMIPRIL versus UNIVASC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: RAMIPRIL versus UNIVASC.
RAMIPRIL vs UNIVASC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Angiotensin-converting enzyme (ACE) inhibitor; inhibits conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion, leading to decreased blood pressure.
Initial: 2.5 mg orally once daily; Maintenance: 2.5-20 mg/day in 1-2 divided doses; Maximum: 20 mg/day.
Initial: 7.5 mg orally once daily; titrate to 15-30 mg once daily. Maximum: 60 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
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.
The terminal elimination half-life of moexiprilat, the active metabolite, is approximately 9.8 hours in patients with normal renal function. This supports once-daily dosing, though the antihypertensive effect may persist beyond 24 hours with continued therapy.
Primarily renal (60% as unchanged drug and metabolites) and fecal (40% via biliary elimination).
Univasc (moexipril) is primarily eliminated via renal excretion (approximately 50% of absorbed dose as unchanged drug and metabolites) and fecal excretion (about 50%).
Category D/X
Category C
ACE Inhibitor
ACE Inhibitor
"The risk or severity of adverse effects can be increased when Ramipril is combined with Bumetanide."