Ramipril

Ramipril
Clinical data
Trade names	Altace, others
AHFS/Drugs.com	Monograph
MedlinePlus	a692027
License data	US DailyMed: Ramipril;
Routes of; administration	By mouth
ATC code	C09AA05 (WHO) ;
Legal status
Legal status	CA: ℞-only; UK: POM (Prescription only); US: ℞-only;
Pharmacokinetic data
Bioavailability	28%
Protein binding	73% (ramipril); 56% (ramiprilat)
Metabolism	Liver, to ramiprilat
Elimination half-life	13 to 17 hours
Excretion	Kidney (60%) and fecal (40%)
Identifiers
	IUPAC name (2S,3aS,6aS)-1-[(2S)-2-[[(2S)-1-Ethoxy-1-oxo-4-phenylbutan-2-yl]amino]propanoyl]-3,3a,4,5,6,6a-hexahydro-2H-cyclopenta[b]pyrrole-2-carboxylic acid;
CAS Number	87333-19-5 ;
PubChem CID	5362129;
IUPHAR/BPS	6339;
DrugBank	DB00178 ;
ChemSpider	4514937 ;
UNII	L35JN3I7SJ;
KEGG	D00421 ;
ChEBI	CHEBI:8774 ;
ChEMBL	ChEMBL1168 ;
CompTox Dashboard (EPA)	DTXSID8023551 ;
ECHA InfoCard	100.170.726
Chemical and physical data
Formula	C23H32N2O5
Molar mass	416.518 g·mol−1
3D model (JSmol)	Interactive image;
Melting point	109 °C (228 °F)
	SMILES O=C(OCC)[C@@H](N[C@H](C(=O)N1[C@H](C(=O)O)C[C@@H]2CCC[C@H]12)C)CCc3ccccc3;
	InChI InChI=1S/C23H32N2O5/c1-3-30-23(29)18(13-12-16-8-5-4-6-9-16)24-15(2)21(26)25-19-11-7-10-17(19)14-20(25)22(27)28/h4-6,8-9,15,17-20,24H,3,7,10-14H2,1-2H3,(H,27,28)/t15-,17-,18-,19-,20-/m0/s1 ; Key:HDACQVRGBOVJII-JBDAPHQKSA-N ;
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Ramipril, sold under the brand name Altace among others, is an ACE inhibitor type medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It can also be used as a preventative medication in patients over 55 years old to reduce the risk of having a heart attack, stroke or cardiovascular death in patients shown to be at high risk, such as some diabetics and patients with vascular disease. It is a reasonable initial treatment for high blood pressure. It is taken by mouth.

Common side effects include headaches, dizziness, feeling tired, and cough. Serious side effects may include liver problems, angioedema, kidney problems, and high blood potassium. Use in pregnancy and breastfeeding is not recommended. It is an ACE inhibitor and works by decreasing renin-angiotensin-aldosterone system activity.

Ramipril was patented in 1981 and approved for medical use in 1989. It is available as a generic medication. In 2020, it was the 196th most commonly prescribed medication in the United States, with more than 2 million prescriptions.

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