Ramipril — NZ Medication Guide | KiwiMeds
✅ Reviewed by a Registered Pharmacist NZ | Last updated: May 2026 | This information is for educational purposes only and does not replace advice from your doctor or pharmacist.
What is Ramipril?
Ramipril is an ACE inhibitor — a type of blood pressure medicine that also protects the heart and kidneys. It is commonly prescribed in New Zealand for high blood pressure, heart failure, and after heart attacks.
What is it used for?
Ramipril is used to treat high blood pressure, heart failure, and to reduce the risk of heart attack, stroke, and kidney problems in people at high cardiovascular risk (including those with diabetes, peripheral arterial disease, or stroke history). It is fully funded by Pharmac.
How does it work?
Ramipril blocks the enzyme that produces angiotensin II, a chemical that constricts blood vessels. By preventing this, ramipril relaxes blood vessels, lowers blood pressure, and reduces the workload on the heart. It also helps protect the kidneys from the effects of high blood pressure and diabetes.
How to take it
Ramipril is usually taken once or twice daily as directed by your doctor. It can be taken with or without food. Take it at the same time each day. Do not stop taking it suddenly without talking to your doctor.
Common side effects
Common side effects include a dry persistent cough (very common with all ACE inhibitors — up to 1 in 5 people), dizziness (especially when standing up quickly), headache, fatigue, nausea, and high potassium levels.
Serious side effects to watch for
Seek immediate medical help for: sudden swelling of the face, lips, tongue, or throat (angioedema — rare but serious), severe dizziness or loss of consciousness, signs of kidney problems, and dangerously high potassium (muscle weakness, heart rhythm changes).
Important drug interactions
NSAIDs (ibuprofen, diclofenac) can reduce ramipril’s effectiveness and increase the risk of kidney problems. Potassium supplements, potassium-sparing diuretics, and salt substitutes can cause dangerously high potassium. Other blood pressure medicines may enhance blood pressure lowering effect.
Things to avoid
Avoid NSAIDs for pain relief — use paracetamol instead. Avoid potassium supplements and salt substitutes (most contain potassium). Avoid alcohol in excess. Ramipril must not be used in pregnancy.
NZ-specific information
Ramipril is fully funded by Pharmac. Available as Ramace and generic brands. Regular blood pressure and kidney function monitoring is recommended. If cough is intolerable, your doctor may switch to an ARB such as candesartan or losartan.
Frequently asked questions
What is the difference between ramipril and lisinopril? Both are ACE inhibitors with similar effectiveness. Ramipril is often preferred after heart attacks due to strong evidence from clinical trials. Can I stop ramipril if I feel dizzy? Do not stop without talking to your doctor — they can adjust the dose or timing.
💬 Always talk to your pharmacist or doctor for advice specific to you. This guide is for general information only and does not replace a professional consultation.
Related medications
Related: Lisinopril, Amlodipine. Condition: Hypertension.
References & Further Information
The following New Zealand and international resources were used to inform this page: