Hi, I'm new to this forum but have been reading with interest about other people's experience of Ramipril. I was put on Nifedipine last year, then had Ramipril added but was switched to 5mg Ramipril only in June by a new doctor. All seemed fine at first, pressure was down and have felt well - not had the cough other people mention (interestingly I asked for the tablets not the capsules as I'm vegetarian). I've had anxiety and depression but that has been around for a couple of years since I lost my mum and I'm not taking any meds for it. I have recently had some emotional stress for a few weeks - and my blood pressure had gone up when I went for my prescription review last week. I also found that previous blood tests showed issues with my kidneys - levels had dropped to 74 but gone up again to 83 - I had no idea. I didn't want a higher dose as have since made changes to ease this stress but I was increased to 10mg anyway on Friday and by yesterday (Sunday) evening blood pressure had gone through the roof, over 200! I rang 111 as arm was a bit tingly but they said to just see my GP today. I have an appointment tonight. I have a naturally low heart rate, around 58/59 - but it has dropped to nearer 54/56 over the weekend when at rest. So heart rate down and blood pressure up! Has anyone else had a similar experience? I'm 48, fairly active (weekends steps usually around 15k a day, weekdays less due to work), been an ex smoker for 15 months - hardly drink now either and about a stone overweight (since not smoking!). I don't think I suit the higher dose but it is hard to find what the alternatives are. Any suggestions welcome. Thanks.
Ramipril dose increase - BP has soared - British Heart Fou...
Ramipril dose increase - BP has soared
Think you are doing the most sensible thing by seeking advice later today. What time of day do you take your Ramipril?
Thank you - first thing in the morning usually. Now I've been upped to 10mg I am taking 5mg first thing and 5mg 12 hours later (so 10mg a day total) to use up my old tablets until new ones come in this week and then it will be 10mg in the morning. Does when you take it make a difference?
Time of day can affect some in differing ways. I have taken 10mg for years but always in the morning and although you are doing 2 x 5mg it may be better to have them both at the same time rather than spread across the day but to be on the safe side would suggest you seek advice on that first.
Thank you - I will mention it this evening, I've never been advised one way or the other! Much appreciated.
Have you still got the Patient Leaflet? If so have a read of it otherwise medicines.org.uk/emc/produc...
10 mg Ramipril is not a huge dose. Perhaps you need to be taking two classes of BP medication. You are on an ACE inhibitor and, perhaps need a calcium channel blocker or a diuretic added. I am on low doses of ramipril, amlodipine, doxazosin and bendroflumethiazide and that keeps all in order. You might find the NICE guidance helpful:
nice.org.uk/guidance/ng136/...
I was originally on Nifedipine (a CCB) and Ramipril but it was changed, I don't know why - new doctor. Now it is just Ramipril. Thanks for the link, will have a read.
Hello and welcome to the forum! You are doing the best thing in seeing your GP. Sometimes a combination therapy works better for BP control ; e. g. an ACE inhibitor and a CCI (calcium channel inhibitor). Also take your BP meter to the appointment to check its calibration. Good luck.
Thank you! 
And good shout to take the monitor with me, I will do that. I have tried to make the recommended lifestyle changes over the last couple of years - although I've always eaten healthily and been active. Stress and anxiety seem to be a factor for me - though I have seen on here some people think Ramipril can actually cause anxiety? Everyone is different, so it is hard to make comparisons and connections. I didn't get the cough others mentioned.
Beta blockers, like Bisoporol, reduce stress in some people besides reducing BP and pulse rate. Might be worth dropping in the conversation tonight.
Oh thanks, my knowledge of all these drugs is only of what I’ve been given. I was trying to discuss alternatives and options last week but they’re so pushed for time it is, here’s your pills off you go. At the doctors with my BP machine!
How have you got on?
I think I broker her blood pressure machine! I’ve been given Amlodipine 5mg in addition to the 10mg Ramipril. Can take together first thing. I have blood tests next week to check on kidney function, to see if affected by the Ramipril, and I’ll go back in a month for review - or before if no change. I mentioned tingling in arm but she did t seem concerned, just wanted to give me pills to get it down. Presumably the tingling is the high blood pressure. My only concern was googling accelerated hypertension. She said it will take a few days to see a difference usually. Thank you, and others, for listening - it’s scary to go through.
Amlodapine is a CCI (calcium channel inhibitor) used to treat BP and as an anti-agnial. It is generally tolerated well but can cause oedema. This, if it occurs, is generally treated with a diuretic which also tends to lower BP. Let us k ow how things are in a few days..
Do you drink plenty of fluids? Rampiril stays in your system for about 12 hours and can cause BP variations, high and low, Been told to take mine before bedtime
Hi, thanks - I did ask the GP yesterday when to take it but she said whenever, just at the same time every day. I've got into the habit of first thing in the morning. Drinking enough water is something I'm rubbish at - I drink gallons of tea and the odd coffee, and a lot of milk - but water is something I have to make an effort for, I know it is something I should do.
I was told to take the Rampiril at bedtime after experiencing a fainting session. The cardiologist informed me that this can be caused by rampiril dropping blood pressure a bit too much.. He also told me to take in an extra pint of water between meals so that I drink about 2.5 litres a day. No more faints, driving resumed.
Update to my original post - at the end of November my blood pressure was over 200 and I was taken to A&E. After checks and being released they said stick to the 10mg dose of Ramipril but come off Amlodopine and only use if it goes over 180 to bring it down. If it goes over 200, come back in. Long story short by Christmas it was regularly 190 to 210 over 100 plus, the Amlodopine was having no effect and by my third trip to A&E they admitted me as it had reached 234 over 141! As I now felt in a safe place, I refused the Ramipril - and my BP came down a lot, my heart rate has increased (a good thing - mine is low) and I've had no more spikes. Upon discharge, I was given 2mg of Doxazosin which promptly made my head spin! The leaflet said start at 1mg so I did - but once again my BP is soaring each evening and last night was 189 over 100. I was given this one (an Alpha-blocker) as it was 'clean' and wouldn't affect the further tests I need in couple of weeks. I've made the decision to stop everything again. I will still keep an eye on it until my appointment at the hypertension clinic in six weeks but the three days last week without drugs were the best I've felt in ages. I can't complain about the care I've had and the fact they are looking at what is causing it. I've found a link between having a hysterectomy and an increase in blood pressure - I had one four years ago at age of 44. No one told me about this link but apparently I should have been given calcium and Vitamin D after. My current doctor has suggested I take this so started these yesterday. Will see how it all goes - Happy New Year to everyone.
Your story sounds so similar to mine! I have been on 10mg of ramipril for two weeks and my bp has gone up too. I contacted my GP and he's arranged a blood test and.a phone consultation after the results. The increased dosage made me feel fatigued for a few days, that's ok now but I seem to have got awful constipation. Never had problems with constipation ever, and I couldn't see any info on the contraindications about that. It seems ramipril causes a lot of problems looking at other people's experiences. I feel really miserable with the whole process. I was on atenolol for 19 years, my bp started going up so GP changed prescription to ramipril a year ago, nothing but problems since, palpitations, dizziness ...bp worse than ever! So completely sympathise with you.
Hi, so sorry you are having such a miserable time with the Ramipril. It is hard enough isn't it, worrying about blood pressure and then the meds make it worse. Since writing the above, I was put on Lercanidipine, 10mg. That was about May, and I then started HRT about July - this has been a real turning point as hormones have become balanced again, I can finally shift some of the weight and my BP has come down a lot. By September, I was getting readings of about 130/75 - hurrah! I did the Fast800 diet which seemed to suit me and help get the blood pressure under control. I put on a few pounds at Christmas and have just managed to shift these (so quick to go on but slow to come off!), but still trying to lose a bit more as it does help my BP. If you are able to go back to your GP, I would. I was actually referred to the hypertension clinic at the hospital last year - that may be worth a try (although it has been postponed for a while due to Covid). I hope you find your solution soon, good luck.
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