Ramipril

Ramipril

Drug monograph · NCLEX study reference
Trade names	Altace
Therapeutic class	Antihypertensive, cardiovascular protection
Pharmacologic class	ACE inhibitor
Onset / peak / duration	Onset 1 to 2 hours; peak 3 to 6 hours; duration about 24 hours.
Half-life / level	Effective half-life 13 to 17 hours; no routine level.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	None specific.
Pregnancy / lactation	Contraindicated.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Ramipril (brand name Altace) — Antihypertensive, cardiovascular protection; ACE inhibitor.

Identification

• Therapeutic class: Antihypertensive, cardiovascular protection.
• Pharmacologic class: ACE inhibitor.

Pharmacology

• Mechanism of action: Same ACE inhibition; strong evidence for cardiovascular event reduction.
• Onset / peak / duration: Onset 1 to 2 hours; peak 3 to 6 hours; duration about 24 hours.
• Half-life / therapeutic level: Effective half-life 13 to 17 hours; no routine level.

Clinical use

• Indications: Hypertension, heart failure post-MI, reduction of cardiovascular risk in high-risk patients.
• Usual dose, route, frequency: 2.5 to 20 mg PO daily in 1 to 2 doses.
• Maximum dose / adjustments: Max 20 mg/day; reduce in renal impairment.

Safety

• Contraindications: Angioedema history, pregnancy, bilateral renal artery stenosis.
• Black box warning: Fetal toxicity.
• Interactions: Class ACE interactions.
• Pregnancy / lactation: Contraindicated.
• High-alert: No.

Adverse effects

• Common side effects: Cough, dizziness, headache.
• Serious effects to report: Angioedema, hyperkalemia, renal impairment.
• Antidote / reversal: None specific.

Nursing process

• Assessment before administration: Blood pressure, renal function, potassium, pregnancy status.
• Interventions during therapy: Capsule may be opened and sprinkled on applesauce if needed.
• Monitor: Blood pressure, potassium, renal function.
• Evaluation / expected outcome: Reduced cardiovascular risk; controlled blood pressure.

Patient teaching

• Patient teaching: Long-term protective therapy.
• Notify provider if: Swelling, breathing difficulty, persistent cough.
• Administration tips: Consistent daily timing.